Incidence, Characteristics, and Management of Venous Thrombosis in Adult Patients With Immune Thrombocytopenia: Results From the Multicenter, Prospective Registry CARMEN‐France

Adult patients with immune thrombocytopenia (ITP) have an increased risk of venous thrombosis as compared to the general population. The management of ITP in the context of anticoagulation is challenging. We conducted an observational study in the prospective, multicenter, national CARMEN-France registry. Adult patients with newly diagnosed ITP between June 2013 and May 2022 were selected. We assessed the cumulative incidence of venous thrombosis during follow-up with death as a competing event, described these events, and assessed patient outcomes depending on management strategies, with a focus on thromboses that occurred during treatment with thrombopoietin receptor agonists (TPO-RA). Among the 1303 patients selected for this study, 53 experienced venous thrombosis. The cumulative incidence of venous thrombosis was 2.6% (95% CI: 1.8-3.7) at 1 year and 8.6% (95% CI: 5.8-12.0) at 5 years. In patients exposed to TPO-RA, the cumulative incidence was 9.3% (95% CI: 6.2-13.2) and 13.4% (95% CI: 8.6-19.2) at 1 and 5 years of exposure, respectively. Patients who experienced thrombosis were older, had more frequently a history of venous thrombosis and secondary ITP, a more severe ITP, and were more frequently treated with TPO-RAs. Twenty (37.7%) of the 53 events were atypical, including five cerebral venous thromboses. Four patients died, and seven experienced major bleeding. The analysis of different managements of ITP after the thrombotic event suggested that the safest strategy was to promptly control ITP to enable early anticoagulation, including using TPO-RAs. Long-term anticoagulation therapy should be considered in patients treated with TPO-RAs and persistent risk factors for thrombosis.

Authors

Institutions

Publication Details

Journal
American Journal of Hematology
Published
2026-01-08
DOI
https://doi.org/10.1002/ajh.70192
Primary Topic
Platelet Disorders and Treatments
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Incidence, Characteristics, and Management of Venous Thrombosis in Adult Patients With Immune Thrombocytopenia: Results From the Multicenter, Prospective Registry CARMEN‐France

D. Gobert, Quitterie Reynaud, T. Moulinet, B. Godeau et al.
American Journal of Hematology
Platelet Disorders and Treatments
article

Incidence, Characteristics, and Management of Venous Thrombosis in Adult Patients With Immune Thrombocytopenia: Results From the Multicenter, Prospective Registry CARMEN‐France

D. Gobert, Quitterie Reynaud, T. Moulinet, B. Godeau, F. Therme, M. Ruivard, Matthieu Mahévas, Guillaume Moulis, Yoann Zadro, Mikaël Ebbo, Manuela Rueter, Maryse Lapeyre‐Mestre, Sylvain Audia, Pierre‐Yves Jeandel, Philippe Guilpain, Thibault Comont, L. Terriou, C. Gourguechon, Marc Michel, Laurie Chabbert, Bernard Bonnotte, Stéphane Chèze, Jean Francois Viallard, The Carmen‐France Investigators Group, Ailsa Robbins
article en

Abstract

Adult patients with immune thrombocytopenia (ITP) have an increased risk of venous thrombosis as compared to the general population. The management of ITP in the context of anticoagulation is challenging. We conducted an observational study in the prospective, multicenter, national CARMEN-France registry. Adult patients with newly diagnosed ITP between June 2013 and May 2022 were selected. We assessed the cumulative incidence of venous thrombosis during follow-up with death as a competing event, described these events, and assessed patient outcomes depending on management strategies, with a focus on thromboses that occurred during treatment with thrombopoietin receptor agonists (TPO-RA). Among the 1303 patients selected for this study, 53 experienced venous thrombosis. The cumulative incidence of venous thrombosis was 2.6% (95% CI: 1.8-3.7) at 1 year and 8.6% (95% CI: 5.8-12.0) at 5 years. In patients exposed to TPO-RA, the cumulative incidence was 9.3% (95% CI: 6.2-13.2) and 13.4% (95% CI: 8.6-19.2) at 1 and 5 years of exposure, respectively. Patients who experienced thrombosis were older, had more frequently a history of venous thrombosis and secondary ITP, a more severe ITP, and were more frequently treated with TPO-RAs. Twenty (37.7%) of the 53 events were atypical, including five cerebral venous thromboses. Four patients died, and seven experienced major bleeding. The analysis of different managements of ITP after the thrombotic event suggested that the safest strategy was to promptly control ITP to enable early anticoagulation, including using TPO-RAs. Long-term anticoagulation therapy should be considered in patients treated with TPO-RAs and persistent risk factors for thrombosis.

American Journal of HematologyVol. 101(3)
Université de Bordeaux (FR), Université Fédérale de Toulouse Midi-Pyrénées (FR), Université de Montpellier (FR), Université Côte d'Azur (FR), Université de Lille (FR), Centre Hospitalier Universitaire de Nice (FR), Sorbonne Université (FR), Assistance Publique Hôpitaux de Marseille (FR), Lille’s Cardiology Hospital (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Toulouse Mathematics Institute (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Hospices Civils de Lyon (FR), Hôpital Saint-Antoine (FR), University of Clermont Auvergne (FR), Centre Hospitalier Universitaire de Reims (FR), Bordeaux Population Health (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Hôpitaux Universitaires Henri-Mondor (FR), Maison des Sciences sociales et des Humanités de Dijon (FR), Université de Reims Champagne-Ardenne (FR), Université de Caen Normandie (FR)
Good health and well-being
Openalex Percentile: Top 96%
Platelet Disorders and Treatments
DOISourceOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.