Contributions
Abstract: PB2317
Type: Publication Only
Background
Polycythemia vera (PV) is a clonal chronic, progressive myeloproliferative disease, resulting from transformation of pluripotent hematopoietic stem cell. Essential thrombocythemia (ET) is a clonal disorder of unknown aetiology that involves multipotent hematopoietic stem cell, and it is characterized by increased formation of megakaryocytes in the bone marrow and distinctively increased platelet counts in peripheral blood without apparent cause. Hemorrhagic syndrome is the kind of complications occurring in about a quarter of patients with PV and reaching even 60% in patients with ET. Bleeding occurs due to ineffective megakaryocytopoiesis, retention of platelets in the large spleen, qualitative platelet disorders, acquired deficiency of factors V and vWF, disseminated intravascular coagulation.
Aims
The aim of this study is to monitor the count of erythrocytes, leukocytes and platelets, as well as hemoglobin and hematocrit values, as well as the presence of JAK2V617F mutation as potential risk factors for the incidence of hemorrhagic complications in patients with polycythemia vera and essential thrombocythemia.
Methods
During the five-year period we monitored the occurrence of hemorrhagic complications in 66 patients (of both sexes, aged between 30 and 78 years), being diagnosed with PV and 28 patients (of both sexes, aged between 38 and 79 years), being diagnosed with ET. We used methods of clinical, laboratory, ultrasound and CT scans. The following possible risk factors were monitored: counts of erythrocytes, leukocytes and platelets, hemoglobin and hematocrit values, as well as the presence of JAK2V617F mutation. Aspirin administration was also monitored for prophylaxis of thrombotic complications.
Results
The highest percentage of hemorrhagic complications were in the group of patients with ET and then in the group with PV . In both groups, the incidence of hemorrhagic complications in patients older than 65 years of age was higher. The highest erythrocyte count, the highest hemoglobin and hematocrit values, as well as the highest leukocyte count was recorded in the group of patients with PV. The highest platelet count was found in the group of patients with ET . Hemorrhagic complications were more frequent in patients with platelet count over 1000x109/L . JAK2V617F mutation was more commonly reported in patients with PV (89%). In those patients, the hemorrhagic complications were also slightly more frequent than in the group of JAK2 negative patients. In patients with ET, the percentage of JAK2V617F positive patients was 48. There was no statistical significance regarding the occurrence of hemorrhagic complications between JAK2 positive and JAK2 negative patients. About 70% of patients with PV and ET were put on prophylactic administration of Aspirin. Studies have shown that statistically significant number of patients from both groups, who were on the prophylactic administration of Aspirin, showed some of the hemorrhagic complications.
Conclusion
The platelet count can be considered as a significant parameter for monitoring the risk of hemorrhagic complications in patients with ET and PV. The presence of JAK2V617F mutation as a risk factor for the development of hemorrhagic complications can be considered in the context of other risk factors. Monitoring of patients who were on the prophylactic administration of Aspirin had special importance, particularly when other risk factors for prevalence of hemorrhagic complications were present.
Session topic: 16. Myeloproliferative neoplasms - Clinical
Keyword(s): Essential Thrombocytemia, Myeloproliferative disorder, Polycythemia vera
Abstract: PB2317
Type: Publication Only
Background
Polycythemia vera (PV) is a clonal chronic, progressive myeloproliferative disease, resulting from transformation of pluripotent hematopoietic stem cell. Essential thrombocythemia (ET) is a clonal disorder of unknown aetiology that involves multipotent hematopoietic stem cell, and it is characterized by increased formation of megakaryocytes in the bone marrow and distinctively increased platelet counts in peripheral blood without apparent cause. Hemorrhagic syndrome is the kind of complications occurring in about a quarter of patients with PV and reaching even 60% in patients with ET. Bleeding occurs due to ineffective megakaryocytopoiesis, retention of platelets in the large spleen, qualitative platelet disorders, acquired deficiency of factors V and vWF, disseminated intravascular coagulation.
Aims
The aim of this study is to monitor the count of erythrocytes, leukocytes and platelets, as well as hemoglobin and hematocrit values, as well as the presence of JAK2V617F mutation as potential risk factors for the incidence of hemorrhagic complications in patients with polycythemia vera and essential thrombocythemia.
Methods
During the five-year period we monitored the occurrence of hemorrhagic complications in 66 patients (of both sexes, aged between 30 and 78 years), being diagnosed with PV and 28 patients (of both sexes, aged between 38 and 79 years), being diagnosed with ET. We used methods of clinical, laboratory, ultrasound and CT scans. The following possible risk factors were monitored: counts of erythrocytes, leukocytes and platelets, hemoglobin and hematocrit values, as well as the presence of JAK2V617F mutation. Aspirin administration was also monitored for prophylaxis of thrombotic complications.
Results
The highest percentage of hemorrhagic complications were in the group of patients with ET and then in the group with PV . In both groups, the incidence of hemorrhagic complications in patients older than 65 years of age was higher. The highest erythrocyte count, the highest hemoglobin and hematocrit values, as well as the highest leukocyte count was recorded in the group of patients with PV. The highest platelet count was found in the group of patients with ET . Hemorrhagic complications were more frequent in patients with platelet count over 1000x109/L . JAK2V617F mutation was more commonly reported in patients with PV (89%). In those patients, the hemorrhagic complications were also slightly more frequent than in the group of JAK2 negative patients. In patients with ET, the percentage of JAK2V617F positive patients was 48. There was no statistical significance regarding the occurrence of hemorrhagic complications between JAK2 positive and JAK2 negative patients. About 70% of patients with PV and ET were put on prophylactic administration of Aspirin. Studies have shown that statistically significant number of patients from both groups, who were on the prophylactic administration of Aspirin, showed some of the hemorrhagic complications.
Conclusion
The platelet count can be considered as a significant parameter for monitoring the risk of hemorrhagic complications in patients with ET and PV. The presence of JAK2V617F mutation as a risk factor for the development of hemorrhagic complications can be considered in the context of other risk factors. Monitoring of patients who were on the prophylactic administration of Aspirin had special importance, particularly when other risk factors for prevalence of hemorrhagic complications were present.
Session topic: 16. Myeloproliferative neoplasms - Clinical
Keyword(s): Essential Thrombocytemia, Myeloproliferative disorder, Polycythemia vera