Elevated neutrophil extracellular traps in patients with BCR::ABL1-negative myeloproliferative neoplasms: pathophysiological insight beyond thrombosis?

Introduction Neutrophil extracellular traps (NETs) are webs composed of decondensed DNA, histones, and cytotoxic proteins released by activated neutrophils. While NETs are implicated in sepsis and cancer, their role in BCR::ABL1 -negative myeloproliferative neoplasms (MPN) remains poorly understood. Thrombosis remains a major challenge in MPN, indicating the importance of deeper insight into thromboinflammatory mechanisms. This study aimed to determine the contribution of NETs to MPN pathophysiology and thrombosis. Method Blood samples from 112 MPN patients ([ Fig. 1 ]) and 20 healthy donors were collected. Histone H3.1, a core nucleosomal protein, is released during NET formation and can be detected in plasma. H3.1 nucleosomes, as surrogate NET markers, were quantified by ELISA according to the manufacturer’s protocol [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]. Results NET concentrations were significantly elevated in MPN patients compared to healthy donors (median 292.6 ng/mL versus 55.8 ng/mL, p