Rafet EREN, Mehmet Hilmi DOĞU, Alper KOÇ, Şermin ALTINDAL, Osman YOKUŞ, Elif SUYANI

Esansiyel trombositemi hastalarında kemik iliği fibrozisi ile ortalama trombosit hacmi ve plateletkritin ilişkisi: Bir kohort çalışma

Amaç: Esansiyel trombositemi (ET) hastalarında ortalama trombosit hacmi (MPV) değerleri sağlıklı bireylere göre daha yüksek seyretmektedir. Ancak, ET’da MPV veya plateletkritin (PCT) kemik iliği fibrozisi (KİF) derecesi ile ilişkisi henüz araştırılmamıştır. Amacımız MPV ve PCT değerlerinin ET hastalarında kemik iliği fibrozisini değerlendirmede prediktif bir belirteç olarak rolünü araştırmaktır.Yöntemler: Retrospektif bir kohort çalışması yaparak Ocak 2015 ile Aralık 2016 arasında hematoloji polikliniğimizden takip edilen ET hastalarının verilerini inceledik. 18 yaşından büyük, tanı anında kemik iliği biyopsisi, hemogram, biyokimya ve batın ultrasonu olan, JAK2 istenmiş olan ve BCR-ABL negatif hastalar çalışmaya dâhil edildi. Hastalar KİF varlığına göre “KİF grubu” ve “KİF olmayan grup” olarak iki gruba ayrıldı. MPV ve PCT için eşik değer için ortanca değer alındı. Karşılaştırmalı istatistiksel analizler için Fisher exact ve ki kare testi kullanıldı.Bulgular: Hastaların 22’si erkek 26’sı kadın olup ortanca yaş 56 yaştı (Aralık 28-81). KİF grubunda 35 (%73) hasta varken KİF olmayan grupta 13 (%27) hasta mevcuttu. Medyan MPV 8,8 fL (6,6-11,5) iken medyan PCT %0,69 (0,42-2,26) idi ve bunlar iki parametre için eşik değer olarak kullanıldı. KİF varlığı ile MPV ≤8,8 fL ve MPV >8,8 fL olan hastalar arasında, PCT ≤%0,69 ve PCT >%0,69 olanlardaki gibi anlamlı fark bulunmamaktaydı (p=0,104 ve 0,616). Sonuç: Çalışmamızda ET hastalarında KİF ile MPV veya PCT arasında ilişki bulamadık. Bununla birlikte çalışmamız ET hastalarında KİF’ni öngörmede MPV ve PCT’nin rolünü araştıran ilk çalışmadır.

Anahtar Kelimeler:

Esansiyel trombositemi, Ortalama trombosit hacmi, Plateletkrit, Kemik iliği fibrozisi

The association of mean platelet volume and platecrit and bone marrow fibrosis in patients with essential thrombocythemia: A cohort study

Aim: Essential thrombocythemia (ET) patients exhibit higher mean platelet volume (MPV) values compared to the healthy individuals. However, the association of degree of bone marrow fibrosis with either MPV or platecrit (PCT) has not been evaluated previously. The aim of this study was to investigate MPV and PCT values as predictive markers for evaluating bone marrow fibrosis (BMF) in ET patients. Methods: We conducted a retrospective cohort study to analyze the data of ET patients, who were followed in out-patient clinic of our hematology department, between January 2015 and December 2016. Patients older than 18 years, who had bone marrow biopsy, CBC, biochemistry tests and an abdominal sonography performed at the time of diagnosis, JAK2 test ordered and were BCR-ABL negative were included in the study. The patients were divided into two groups according to the presence of BMF as “the BMF group” and “the non-BMF group”. The cut-off value for MPV and PCT was determined according to the median value. Fisher’s exact test and χ2 were used for comparative statistical analysis.Results: There were 22 males and 26 females with a median age of 56 years (range, 28–81). The BMF group included 35 (73%) patients while the non-BMF group included 13 (27%) patients. The median MPV was 8.8 fL (6.6-11.5) and median PCT was 0.69% (0.42-2.26), which was considered as the cut-off values for these parameters. There was no significant difference between the groups in patients with MPV ≤8.8 fL and MPV >8.8 fL (p=0.104) and also in patients with PCT ≤0.69% and PCT >0.69% (p=0.616).Conclusion: There is no association between the BMF and MPV and PCT in ET patients. However this is the first study investigating the role of both MPV and PCT in BMF in ET patients.

Keywords:

Essential thrombocythemia, Mean platelet volume, Platecrit, Bone marrow fibrosis,

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