A Temporal Examination of Platelet Counts as a Predictor of Prognosis in Lung, Prostate, and Colon Cancer Patients

Abstract

Platelets, components of hemostasis, when present in excess (>400 K/μL, thrombocytosis) have also been associated with worse outcomes in lung, ovarian, breast, renal, and colorectal cancer patients. Associations between thrombocytosis and cancer outcomes have been made mostly from single-time-point studies, often at the time of diagnosis. Using laboratory data from the Department of Veterans Affairs (VA), we examined the potential benefits of using longitudinal platelet counts in improving patient prognosis predictions. Ten features (summary statistics and engineered features) were derived to describe the platelet counts of 10,000+ VA lung, prostate, and colon cancer patients and incorporated into an age-adjusted LASSO regression analysis to determine feature importance, and predict overall or relapse-free survival, which was compared to the previously used approach of monitoring for thrombocytosis near diagnosis (Postdiag AG400 model). Temporal features describing acute platelet count increases/decreases were found to be important in cancer survival and relapse-survival that helped stratify good and bad outcomes of cancer patient groups. Predictions of overall and relapse-free survival were improved by up to 30% compared to the Postdiag AG400 model. Our study indicates the association of temporally derived platelet count features with a patients’ prognosis predictions.

Laboratory‐wide association study of survival with prostate cancer

“…Prior studies have reported associations between C‐reactive protein 26 and the erythrocyte sedimentation rate 27 and mortality in patients with localized prostate cancer. These LWAS findings have confirmed prior reports demonstrating that markers of the systemic inflammatory response are associated with mortality among patients diagnosed with cancer 28,29 . To the best of our knowledge, the question of whether these findings more broadly reflect the overall health of a patient, the systemic effects of cancer before a formal diagnosis of prostate cancer, or a susceptibility to cancer progression is unknown.…”

The clinical significance of preoperative plasma fibrinogen levels and platelet counts in resectable colon cancer

“…Several types of cancer, especially gastric, colorectal, pancreatic, prostate, lung, and esophageal squamous cell carcinomas, have been associated with elevated plasma fibrinogen levels and PLT counts [2,[8][9][10]. The current study findings showed that patients with negative lymph nodes have significantly lower PLT counts and fibrinogen levels than patients with positive lymph nodes.…”

Hepatic thrombopoietin gene silencing reduces platelet count and breast cancer progression in transgenic MMTV-PyMT mice

“…It is also not known whether selective silencing of hepatic THPO would also reduce platelet count or improve outcomes in cancer-associated thrombocytosis in humans, observed in 15% to 40% of solid tumor patients. 52 In a thorough pioneering study, Stone and colleagues have documented reduction of experimental paraneoplastic thrombocytosis and associated antineoplastic effects using a TPO small interfering RNA, with or without also inhibiting interleukin-6. 3 This indicated that paraneoplastic thrombocytosis is responsive to THPO gene silencing in some mouse models.…”