ISSN 1866-8836
Клеточная терапия и трансплантация

MP-08. Evaluation of hemostatic balance in patients with Ph-negative myeloproliferative neoplasms

Natalia N. Silina, Olga G. Golovina, Natalia E. Korsakova, Olesya Yu. Matvienko, Elizaveta V. Efremova, Sergey V. Voloshin

Russian Research Institute of Hematology and Transfusiology, St. Petersburg, Russia


Contact: Dr. Natalia N. Silina, phone: +7 (921) 787-16-35, e-mail: nnper37@gmail.com

doi 10.18620/ctt-1866-8836-2023-12-3-1-176

Summary

Thrombosis is a frequent complication of polycythemia vera (PV), essential thrombocytemia (ET) and primary myelofibrosis (PMF). The integral methods are used to identify hypercoagulation as a predictor of thrombosis development. Our aim was to evaluate the hemostatic balance in patients with myeloproliferative neoplasms (MPN).

Materials and methods

We have examined blood clotting in 20 healthy individuals, 59 patients with PMF, 69 with PV and 38 with ET. Their therapy included antiplatelet drug (acetylsalicylic acid – ASA), and targeted cytoreductive treatment used in various combinations. Some of the patients did not receive treatment. The hemostatic balance was calculated by the formula: CI = ЕТРТМ-N/SТМЕТР, where CI is the coagulation index, ЕТРТМ-N is the normalized endogenous thrombin potential of the patient in the thrombin generation test, SТМЕТР reflects sensitivity to thrombomodulin. An increase in CI indicates a change in the hemostatic balance towards hypercoagulation, and its decrease indicates hypocoagulation state. Microsoft Excel and STATISTICA 12.0 programs were used for statistical evaluation.

Results

A significant increase in CI was noted in patients with PMF receiving ruxolitinib or without therapy (Me; Q1-Q3: 5.34; 2.98-11.43, 3.19; 2.37-7.28 versus 1.91; 1.61-1.17 in healthy individuals, respectively); in patients with PV receiving cytoreductive ±ASA therapy or without treatment (2.40; 1.70-3.29 and 2.70; 1.98-3.61, respectively). Patients with ET tended for increase of this parameter.

Conclusions

An increase in CI in patients with MPN indicates an imbalance in the hemostasis system directed towards hypercoagulation. These changes are most pronounced in the patients without treatment, as well as in those treated with cytoreductive and targeted drugs. Evaluation of hemostatic balance in patients with MPN will allow to personalize the approach to identifying predictors of thrombosis and to consider appropriate preventive measures.

Keywords

Polycythemia vera, essential thrombocytemia, primary myelofibrosis, blood clotting index.



Supplement 12-3
09/30/2023

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doi 10.18620/ctt-1866-8836-2023-12-3-1-176

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