Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia
Impaired platelet production is a mechanism of immune thrombocytopenia (ITP). Morphological abnormalities of megakaryocytes (MKs) are sometimes observed in this disease. Two studies have suggested an association between MK abnormalities and response to corticosteroids in primary ITP, but none have i...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-11-01
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| Series: | Platelets |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09537104.2022.2053089 |
| _version_ | 1827816791226712064 |
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| author | Ondine Walter Agnès Ribes Johanne Germain Jean-Baptiste Rieu Thibaut Comont Albertine Plat Brigitte Rivière Laureline Deluche Lucrecia Delarue Isabelle LeGoff Monique Greze Béatrice Dubourdieu Odile Rauzy Veronique Mansat-De Mas Guillaume Moulis the CARMEN investigators group. |
| author_facet | Ondine Walter Agnès Ribes Johanne Germain Jean-Baptiste Rieu Thibaut Comont Albertine Plat Brigitte Rivière Laureline Deluche Lucrecia Delarue Isabelle LeGoff Monique Greze Béatrice Dubourdieu Odile Rauzy Veronique Mansat-De Mas Guillaume Moulis the CARMEN investigators group. |
| author_sort | Ondine Walter |
| collection | DOAJ |
| description | Impaired platelet production is a mechanism of immune thrombocytopenia (ITP). Morphological abnormalities of megakaryocytes (MKs) are sometimes observed in this disease. Two studies have suggested an association between MK abnormalities and response to corticosteroids in primary ITP, but none have investigated this association for thrombopoietin-receptor agonists (TPO-RAs). This was the aim of this study. The source of population was the French CARMEN registry with prospective follow-up of adult patients with incident ITP. We included patients with primary ITP, treated by TPO-RA and with a bone marrow smear before initiating TPO-RA. MK abnormalities were categorized by the presence of dysplasia and by the stage of maturation. Among 451 patients screened, 38 were included in the analysis. There was no difference in the median percentage of dysplastic MKs between responders to TPO-RA (4.0%, 95% confidence interval – CI: 2.3–6.4) and non-responders (4.5%, 95% CI: 0.7–7.1). There was a slightly higher proportion of granular MKs (4.5%, 95% CI: 3–6) and basophilic MKs (30.1%, 95% CI: 21.9–39.1) in non-responders compared to responders (granular: 2.0%, 95% CI: 0–4.1; basophilic: 21.3%, 95% CI: 11.4–40.7). In conclusion, MK abnormalities were not associated with response achievement in ITP patients treated with TPO-RA in this series of 38 patients. |
| first_indexed | 2024-03-12T00:25:40Z |
| format | Article |
| id | doaj.art-ea93cee71d2c4c6995866ba0ae034f84 |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:25:40Z |
| publishDate | 2022-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-ea93cee71d2c4c6995866ba0ae034f842023-09-15T10:38:11ZengTaylor & Francis GroupPlatelets0953-71041369-16352022-11-013381153115810.1080/09537104.2022.20530892053089Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopeniaOndine Walter0Agnès Ribes1Johanne Germain2Jean-Baptiste Rieu3Thibaut Comont4Albertine Plat5Brigitte Rivière6Laureline Deluche7Lucrecia Delarue8Isabelle LeGoff9Monique Greze10Béatrice Dubourdieu11Odile Rauzy12Veronique Mansat-De Mas13Guillaume Moulis14the CARMEN investigators group.Toulouse University HospitalLaboratory of Hematology, Toulouse University HospitalCIC 1436, team PEPSS, Toulouse University HospitalLaboratory of Hematology, Toulouse University HospitalToulouse University HospitalLaboratory of Hematology, Tarbes Hospital, Tarbes, FranceCastres-Mazamet HospitalLaboratory of Hematology, Montauban HospitalLaboratory of Hematology, Cahors HospitalLaboratory of Hematology, Pamiers HospitalLaboratory of Hematology, Albi HospitalLaboratory of Hematology, Rodez HospitalToulouse University HospitalLaboratory of Hematology, Toulouse University HospitalToulouse University HospitalImpaired platelet production is a mechanism of immune thrombocytopenia (ITP). Morphological abnormalities of megakaryocytes (MKs) are sometimes observed in this disease. Two studies have suggested an association between MK abnormalities and response to corticosteroids in primary ITP, but none have investigated this association for thrombopoietin-receptor agonists (TPO-RAs). This was the aim of this study. The source of population was the French CARMEN registry with prospective follow-up of adult patients with incident ITP. We included patients with primary ITP, treated by TPO-RA and with a bone marrow smear before initiating TPO-RA. MK abnormalities were categorized by the presence of dysplasia and by the stage of maturation. Among 451 patients screened, 38 were included in the analysis. There was no difference in the median percentage of dysplastic MKs between responders to TPO-RA (4.0%, 95% confidence interval – CI: 2.3–6.4) and non-responders (4.5%, 95% CI: 0.7–7.1). There was a slightly higher proportion of granular MKs (4.5%, 95% CI: 3–6) and basophilic MKs (30.1%, 95% CI: 21.9–39.1) in non-responders compared to responders (granular: 2.0%, 95% CI: 0–4.1; basophilic: 21.3%, 95% CI: 11.4–40.7). In conclusion, MK abnormalities were not associated with response achievement in ITP patients treated with TPO-RA in this series of 38 patients.http://dx.doi.org/10.1080/09537104.2022.2053089immune thrombocytopeniamegakaryocytesthrombopoietin receptor agonist |
| spellingShingle | Ondine Walter Agnès Ribes Johanne Germain Jean-Baptiste Rieu Thibaut Comont Albertine Plat Brigitte Rivière Laureline Deluche Lucrecia Delarue Isabelle LeGoff Monique Greze Béatrice Dubourdieu Odile Rauzy Veronique Mansat-De Mas Guillaume Moulis the CARMEN investigators group. Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia Platelets immune thrombocytopenia megakaryocytes thrombopoietin receptor agonist |
| title | Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| title_full | Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| title_fullStr | Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| title_full_unstemmed | Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| title_short | Association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| title_sort | association between megakaryocyte abnormalities on bone marrow smear and response to thrombopoietin receptor agonists in adult patients with primary immune thrombocytopenia |
| topic | immune thrombocytopenia megakaryocytes thrombopoietin receptor agonist |
| url | http://dx.doi.org/10.1080/09537104.2022.2053089 |
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