The impact of driver and other somatic mutations on pregnancy outcomes is unknown. The purpose of this study was to report the management and outcome of pregnancies in a cohort of myeloproliferative neoplasms (MPN) patients, particularly to evaluate the impact of somatic mutations. The cohort included consecutive patients with MPN who had a least one confirmed pregnancy. The primary outcome was live births. Secondary outcomes were thrombotic and major bleeding events. Between 2010 and 2021, 29 pregnancies occurred in 24 individuals with MPN. Aspirin was used in 24 cases (83%) and interferon alfa in five (17%). There were 24 live births (83%). There were three thrombotic events, two antepartum and one postpartum. Miscarriages and thrombotic events occurred in JAK2-mutated and triple negative, but not CALR-mutated, MPN. Additional somatic mutations were rare, and there were no apparent associations with pregnancy loss or complications. While JAK2 V617F is associated with an increased risk of thrombosis, its impact on pregnancy outcome has been inconsistently reported. The association between triple negative MPN and adverse pregnancy outcome has not previously been reported. While limited by small numbers, this study underscores the importance of describing driver and other mutations to direct optimal antenatal care in individuals with MPN.

1000 mg/dl or 11.4 mmol/L). The incidence of hypertriglyceridemia associated with PEG-asparaginase in adult patients was high (67.5%). Therefore, checking TGs at baseline and monitoring levels while receiving PEG-asparaginase need to be considered and studied in prospective studies. However, in patients with hypertriglyceridemia not complicated by acute pancreatitis, re-challenging is safe once TG levels normalize.

A 78-year-old male with a history of polycythemia vera (PV) presentedwith bilateral foot ulcerations (a) limiting his ability to exercise or wearshoes. His PV had been managed for the previous 5 years with aspirin81 mg per os (PO) daily, intermittent phlebotomy, and hydroxycarbamide (hydroxyurea [HU]) 1500 mg PO daily. At the time of presentation, his hemoglobin was 138 g/L, hematocrit 0.41, white blood cellcount 14.5 × 109/L, and platelet count 695 × 1012/L. Cultures fromthe right toe ulcer grew Pseudomonas aeruginosa and Streptococcus pyogenes; scintigraphy bone scan demonstrated evidence of osteomyelitisof the right first phalanx. The HU was held and the patient was startedon a 6-week course of ciprofloxacin and doxycycline. Ruxolitinib 10 mgPO BID was initiated for management of PV. Follow-up 3 months later demonstrated significant improvement of the cutaneousulcerations (b).

The safety profile of the novel oral JAK2/IRAK1 inhibitor pacritinib in patients with cytopenic myelofibrosis was described in the Phase 2 PAC203 and Phase 3 PERSIST-2 studies. To account for longer treatment durations on the pacritinib arms compared to best available therapy (BAT), we present a risk-adjusted safety analysis of event rates accounting for different time on treatment. While the rate of overall events was higher on pacritinib compared to BAT, the rate of fatal events was lower, and there was no excess in bleeding, cardiac events, secondary malignancy, or thrombosis on pacritinib, including in patients with severe thrombocytopenia.