Platelet counts and haemorrhagic diathesis in patients with myelodysplastic syndromes.
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Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_156D26735046
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Platelet counts and haemorrhagic diathesis in patients with myelodysplastic syndromes.
Journal
European journal of haematology
ISSN
1600-0609 (Electronic)
ISSN-L
0902-4441
Publication state
Published
Issued date
11/2009
Peer-reviewed
Oui
Volume
83
Number
5
Pages
477-482
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Most patients with myelodysplastic syndromes (MDS) present with single or multiple lineage cytopenias in peripheral blood despite a hypercellular bone marrow. Thrombocytopenia, attributable to ineffective platelet production by dysfunctional megakaryocytes, has been estimated to occur in 40-65% of patients. However, there are hardly any studies on the clinical relevance of low platelet counts in MDS.
We retrospectively analysed data from 2900 patients in the Duesseldorf MDS Registry who were diagnosed at our laboratory between 1982 and 2007.
At the time of diagnosis, 43% of the patients had a platelet count lower than 100 000/microL. Platelets were lower than 20 000/microL in 7% of the patients, especially in those with advanced stages of MDS, who showed a higher frequency of thrombocytopenia and platelet transfusion dependency. On multivariate analysis, platelet anisometry, hypocellularity of megakaryopoiesis, maturational defects of megakaryocytes and platelets <20 000/microL were independent variables showing a statistically significant correlation (P < 0.05) with clinical signs of bleeding. Platelets lower than 100 000/microL were associated with significantly shortened survival (P < 0.00005), because of an increased risk of progression to acute myeloid leukaemia (AML) (30% vs. 21%) (P < 0.02) and bleeding (16% vs. 8%) (P = 0.0005).
Thrombocytopenia is a strong predictor of short survival, with or without haemorrhagic complications.
We retrospectively analysed data from 2900 patients in the Duesseldorf MDS Registry who were diagnosed at our laboratory between 1982 and 2007.
At the time of diagnosis, 43% of the patients had a platelet count lower than 100 000/microL. Platelets were lower than 20 000/microL in 7% of the patients, especially in those with advanced stages of MDS, who showed a higher frequency of thrombocytopenia and platelet transfusion dependency. On multivariate analysis, platelet anisometry, hypocellularity of megakaryopoiesis, maturational defects of megakaryocytes and platelets <20 000/microL were independent variables showing a statistically significant correlation (P < 0.05) with clinical signs of bleeding. Platelets lower than 100 000/microL were associated with significantly shortened survival (P < 0.00005), because of an increased risk of progression to acute myeloid leukaemia (AML) (30% vs. 21%) (P < 0.02) and bleeding (16% vs. 8%) (P = 0.0005).
Thrombocytopenia is a strong predictor of short survival, with or without haemorrhagic complications.
Keywords
Disease-Free Survival, Female, Hemorrhagic Disorders/blood, Hemorrhagic Disorders/complications, Hemorrhagic Disorders/mortality, Hemorrhagic Disorders/therapy, Humans, Leukemia, Myeloid, Acute/blood, Leukemia, Myeloid, Acute/etiology, Leukemia, Myeloid, Acute/mortality, Leukemia, Myeloid, Acute/therapy, Male, Myelodysplastic Syndromes/blood, Myelodysplastic Syndromes/complications, Myelodysplastic Syndromes/mortality, Myelodysplastic Syndromes/therapy, Platelet Count, Platelet Transfusion, Predictive Value of Tests, Registries, Retrospective Studies, Survival Rate, Thrombocytopenia/blood, Thrombocytopenia/complications, Thrombocytopenia/mortality, Thrombocytopenia/therapy
Pubmed
Web of science
Create date
16/07/2019 10:56
Last modification date
21/08/2019 6:08