Haemostatic Profile in Patients of Myeloproliferative Neoplasms-A Tertiary Care Centre Experience
Introduction: Patients of MPN commonly present with abnormalities in laboratory coagulation tests that are consistent with hypercoagulable state. Some individuals with MPN exhibit a pattern of exclusive bleeding or thrombotic events; many others have both bleeding and thrombosis during the cours...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8840/19985_CE(Ra1)_F(AK)_PF1(ROAK)_PFA(AK)_PF2(OPR_P).pdf |
| Summary: | Introduction: Patients of MPN commonly present with
abnormalities in laboratory coagulation tests that are consistent
with hypercoagulable state. Some individuals with MPN exhibit
a pattern of exclusive bleeding or thrombotic events; many
others have both bleeding and thrombosis during the course
of the disease.
Aim: This study was undertaken to assess the haemostatic
defects and platelet functions in patients of MPN.
Materials and Methods: One year prospective study was
conducted at a tertiary care centre in North India in Department
of Pathology in collaboration with Department of Clinical
Haematology. All recently diagnosed cases of MPN along with
30 age and sex matched controls were included. Patients on
antiplatelet drugs, antimyeloproliferative treatment, vitamin K
agonists or antagonists, OCPs, Platelet count <1,00,000/µl,
high grade fever, liver disease, pregnancy were excluded from
this study.
All the patients underwent screening investigations like CBC,
peripheral smear evaluation, BT, PT, aPTT, Protein C and S
measurement (clot based assay) and aggregation studies with
ADP (5µM) (Optical Aggregometry with AGGRO/LINK 8 software
and CHRONOLOG 700 aggregometer).
Results: In present study, 50 cases were included. There
was an occult prothrombotic state, suggested by significantly
(p<0.001) reduced levels of Protein C and Protein S, but no
patient presented with frank thrombosis while 8 out of 50
patients had haemorrhagic manifestations ranging from subdural
haematoma to pin point petechial haemorrhages. Patients of
CML-CP, ET, PV, PMF, MPN-NOS showed significantly reduced
maximal aggregation with ADP (5µM) when compared to control
(p<0.001). MPV also showed a statistically significant increase
in these patients.
Conclusion: Thrombohaemorrhagic complications significantly
affect the morbidity and mortality of MPN patients. This can be
assessed by the use of platelet aggregation studies, Protein C
and S activities and other coagulation studies. Timely diagnosis
of these prothrombotic/haemorrhagic states can decrease the
morbidity in these patients. |
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| ISSN: | 2249-782X 0973-709X |