Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter?
Objective: Platelet aggregation tests and the analysis of thromboxane A2 metabolites [serum thromboxane B2 (TXB2) and urine 11-dehydro TXB2] are used to evaluate the efficacy of aspirin. In myeloproliferative neoplasms (MPNs), the immature platelet fraction (IPF) rises due to enhanced platelet turno...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-03-01
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| Series: | Turkish Journal of Hematology |
| Subjects: | |
| Online Access: | https://tjh.com.tr/jvi.aspx?pdir=tjh&plng=eng&un=TJH-90008 |
| _version_ | 1811160698403684352 |
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| author | Ilgın Koçak Göktürk Işıl Erdoğan Özünal Alican Göktürk Ali Hakan Kaya Güven Yılmaz Olga Meltem Akay Erman Öztürk |
| author_facet | Ilgın Koçak Göktürk Işıl Erdoğan Özünal Alican Göktürk Ali Hakan Kaya Güven Yılmaz Olga Meltem Akay Erman Öztürk |
| author_sort | Ilgın Koçak Göktürk |
| collection | DOAJ |
| description | Objective: Platelet aggregation tests and the analysis of thromboxane A2 metabolites [serum thromboxane B2 (TXB2) and urine 11-dehydro TXB2] are used to evaluate the efficacy of aspirin. In myeloproliferative neoplasms (MPNs), the immature platelet fraction (IPF) rises due to enhanced platelet turnover, and this has been thought to reduce the efficacy of aspirin. This phenomenon is overcome by the recommendation of aspirin intake in divided doses. We aimed to evaluate aspirin efficacy in patients who were receiving aspirin treatment of 100 mg/day.
Materials and Methods: Thirty-eight MPN patients and 30 control patients (non-MPN patients who received a single daily dose of aspirin at 100 mg for nonhematological conditions) were enrolled. IPF, serum TXB2, and urine 11-dehydro TXB2 levels were measured and aggregation tests with arachidonic acid and adenosine diphosphate were performed by light transmission aggregometry (LTA).
Results: Mean IPF and TXB2 levels were higher in the MPN group (p=0.008 and p=0.003, respectively). IPF levels were lower in patients on cytoreductive therapy in the MPN group (p=0.001), but these values were similar between patients on hydroxyurea and the non-MPN group (p=0.72). TXB2 levels did not differ according to hydroxyurea treatment status but were higher in the MPN group compared to non- MPN patients (23.63 ng/mL and 19.78 ng/mL, respectively; p=0.04). TXB2 values were higher in patients with essential thrombocythemia and a history of thrombotic events (p=0.031). No difference was observed in LTA between the MPN and non-MPN patient groups (p=0.513).
Conclusion: Higher levels of IPF and TXB2 in the MPN patient group indicated platelets that could not be inhibited by aspirin. It was observed that patients under cytoreductive therapy had lower IPF values, but the expected decrease in TXB2 levels was not observed. These findings suggest that a lack of response to aspirin may be due to additional intrinsic factors rather than increased platelet turnover. |
| first_indexed | 2024-04-10T06:02:54Z |
| format | Article |
| id | doaj.art-90878c0e010b481caeaf33b92211f79a |
| institution | Directory Open Access Journal |
| issn | 1308-5263 |
| language | English |
| last_indexed | 2024-04-10T06:02:54Z |
| publishDate | 2023-03-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Turkish Journal of Hematology |
| spelling | doaj.art-90878c0e010b481caeaf33b92211f79a2023-03-03T06:46:29ZengGalenos Publishing HouseTurkish Journal of Hematology1308-52632023-03-01401374210.4274/tjh.galenos.2023.2022.0452Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter?Ilgın Koçak Göktürk0https://orcid.org/0000-0001-9193-7541Işıl Erdoğan Özünal1https://orcid.org/0000-0002-5289-7134Alican Göktürk2https://orcid.org/0000-0002-7487-0653Ali Hakan Kaya3https://orcid.org/0000-0003-0496-0984Güven Yılmaz4https://orcid.org/0000-0001-9972-2537Olga Meltem Akay5https://orcid.org/0000-0002-6759-1939Erman Öztürk6https://orcid.org/0000-0002-1559-8047İstanbul Medeniyet University Faculty of Medicine, Department of Internal Medicine, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine, Department of Hematology, İstanbul, TürkiyeUniversity of Health Sciences Türkiye, İstanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Family Medicine, İstanbul, TürkiyeÜmraniye Training and Research Hospital, Clinic of Hematology, İstanbul, TürkiyeUniversity of Health Sciences Türkiye, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Hematology, İstanbul, TürkiyeKoç University Hospital, Department of Hematology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine, Department of Hematology, İstanbul, TürkiyeObjective: Platelet aggregation tests and the analysis of thromboxane A2 metabolites [serum thromboxane B2 (TXB2) and urine 11-dehydro TXB2] are used to evaluate the efficacy of aspirin. In myeloproliferative neoplasms (MPNs), the immature platelet fraction (IPF) rises due to enhanced platelet turnover, and this has been thought to reduce the efficacy of aspirin. This phenomenon is overcome by the recommendation of aspirin intake in divided doses. We aimed to evaluate aspirin efficacy in patients who were receiving aspirin treatment of 100 mg/day. Materials and Methods: Thirty-eight MPN patients and 30 control patients (non-MPN patients who received a single daily dose of aspirin at 100 mg for nonhematological conditions) were enrolled. IPF, serum TXB2, and urine 11-dehydro TXB2 levels were measured and aggregation tests with arachidonic acid and adenosine diphosphate were performed by light transmission aggregometry (LTA). Results: Mean IPF and TXB2 levels were higher in the MPN group (p=0.008 and p=0.003, respectively). IPF levels were lower in patients on cytoreductive therapy in the MPN group (p=0.001), but these values were similar between patients on hydroxyurea and the non-MPN group (p=0.72). TXB2 levels did not differ according to hydroxyurea treatment status but were higher in the MPN group compared to non- MPN patients (23.63 ng/mL and 19.78 ng/mL, respectively; p=0.04). TXB2 values were higher in patients with essential thrombocythemia and a history of thrombotic events (p=0.031). No difference was observed in LTA between the MPN and non-MPN patient groups (p=0.513). Conclusion: Higher levels of IPF and TXB2 in the MPN patient group indicated platelets that could not be inhibited by aspirin. It was observed that patients under cytoreductive therapy had lower IPF values, but the expected decrease in TXB2 levels was not observed. These findings suggest that a lack of response to aspirin may be due to additional intrinsic factors rather than increased platelet turnover.https://tjh.com.tr/jvi.aspx?pdir=tjh&plng=eng&un=TJH-90008thromboxane b2platelet aggregationplateletsarachidonic acidaspirin |
| spellingShingle | Ilgın Koçak Göktürk Işıl Erdoğan Özünal Alican Göktürk Ali Hakan Kaya Güven Yılmaz Olga Meltem Akay Erman Öztürk Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? Turkish Journal of Hematology thromboxane b2 platelet aggregation platelets arachidonic acid aspirin |
| title | Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? |
| title_full | Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? |
| title_fullStr | Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? |
| title_full_unstemmed | Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? |
| title_short | Myeloproliferative Neoplasms and Aspirin: Does Increased Platelet Turnover Matter? |
| title_sort | myeloproliferative neoplasms and aspirin does increased platelet turnover matter |
| topic | thromboxane b2 platelet aggregation platelets arachidonic acid aspirin |
| url | https://tjh.com.tr/jvi.aspx?pdir=tjh&plng=eng&un=TJH-90008 |
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