We report a rare case of a young patient affected by MPN complicated by both cerebral and splanchnic vein thrombosis; the antithrombotic therapies performed has not achieved the required effectiveness. He is now candidate to allo stem-cell-transplantation. The description of this clinical case raises the possibility of explore the possible challenges, regarding systemic anticoagulation and cytoreduction in MPN patients. We suggest a future prospective controlled study to evaluate the benefits of the combined use of DOACs and TKIs in MPN patients with venous thrombosis in atypical locations.

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