Prevalence and Risk Factors of Gastroesophageal Varices in Myeloproliferative Neoplasm Patients with Portal Hypertension in a Tertiary Government Hospital: A 5-year Cross-sectional Study
Sam N Fandood* and Michael Chu
ABSTRACT
Background: Myeloproliferative neoplasms (MPNs) are an established cause of non-cirrhotic portal hypertension and may lead to gastroesophageal varices with significant clinical consequences. However, local data on the burden of varices and associated risk factors among MPN patients remain limited.
Methods: This cross-sectional study included 40 adult patients diagnosed with MPNs who underwent esophagogastroduodenoscopy at a tertiary government hospital between 2021 and 2025. Sociodemographic, clinical, laboratory, and endoscopic data were obtained through chart review. The prevalence of gastroesophageal varices was determined. Logistic regression analyses were performed to identify clinicodemographic factors associated with the presence of varices.
Results: Gastroesophageal varices were identified in 23 patients (57.5%), including esophageal varices alone in 27.5%, gastric varices alone in 2.5%, and combined esophageal and gastric varices in 27.5%. Varices were most prevalent among patients with primary myelofibrosis (78.9%), followed by polycythemia vera (45.5%) and chronic myeloid leukemia (30%). The distribution of variceal size differed significantly across groups (p = 0.024), with small varices observed only among patients with chronic myeloid leukemia. In univariate analysis, age 40–59 years (OR: 0.06; 95% CI: 0.01–0.57; p=0.015) and >60 years (OR: 0.03; 95% CI: 0.00–0.38; p=0.006) were associated with lower odds of varices compared with younger patients. Splenic vein diameter was positively associated with varices (OR: 1.38; 95% CI: 1.05–1.80; p=0.020), while platelet count showed an inverse association (OR: 0.99; 95% CI: 0.99–1.00; p=0.004). On multivariate analysis, only platelet count remained independently associated with varices (adjusted OR: 0.99; 95% CI: 0.98–1.00; p=0.020).
Conclusions: Gastroesophageal varices are highly prevalent among MPN patients with portal hypertension, particularly in primary myelofibrosis. Thrombocytopenia is an independent factor associated with variceal presence and may serve as a practical marker to guide endoscopic surveillance in this high-risk population.
