Increased mean platelet volume (MPV) is an independent predictor of inferior survival in patients with primary and secondary myelofibrosis

Abstract

Neoplastic megakaryopoiesis is a dominant feature of Philadelphia-chromosome-negative myeloproliferative neoplasms (Ph- MPNs), and elevated mean-platelet-volume (MPV) is a common finding in these diseases. The clinical and prognostic significances of MPV in patients with primary (PMF) and secondary myelofibrosis (SMF) have not been reported. We retrospectively analyzed 87 patients with myelofibrosis (66 with PMF, 21 with SMF) treated at our institution. MPV was recorded in addition to other hematological and clinical parameters. MPV was elevated in both PMF and SMF patients in comparison to controls, whereas there was no statistically significant difference between PMF and SMF. Elevated MPV was associated with lower platelets (P = 0.016), higher white blood cells (P = 0.015), higher percentage of circulatory blasts (P = 0.009), higher lactate dehydrogenase (P = 0.011), larger spleen size (P = 0.014) and higher Dynamic International Prognostic score category (P = 0.027), while there was no statistically significant association with driver mutations or degree of bone marrow fibrosis. Higher MPV was univariately associated with inferior overall survival in the whole cohort (HR = 3.82, P = 0.006), PMF (HR = 4.35, P = 0.007) and SMF patients (HR = 7.22, P = 0.034). These associations remained significant in multivariate analyses adjusted for DIPSS. Higher MPV is associated with more aggressive disease features and exhibits powerful independent prognostic properties in both PMF and SMF settings.

Psoriasis and Psoriatic Arthritis Cardiovascular Disease Endotypes Identified by Red Blood Cell Distribution Width and Mean Platelet Volume

“…RDW is perturbed by microvascular, bone marrow, and neurohumoral/neuroendocrine dysfunction. Variation in size of RBCs is a result of bone marrow modulation and disordered production of RBCs [45]. Microvascular abnormalities related to endothelium activation, such as in psoriasis or CVD can result in endothelial cytokine release including IL-6 that can circulate into the marrow and affect erythropoiesis [46].…”

“…RDW, in combination with MPV, may also be interpreted as monitors of bone marrow health. This is demonstrated by increased RDW with age as well as increased rates of hematologic malignancies with higher MPV and RDW which are considered negative independent prognostic factors of survival in myelofibrosis and myelodysplasia [45,51]. In fact Sousa et al, advocated RDW as a novel marker of stress erythropoiesis, which may be induced by systemic inflammatory conditions such as psoriasis [52].…”

<p>Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia</p>

“…13 Whereas, in patients with primary or secondary OMF elevated MPV was associated with worse clinical outcomes and shorter OS in the whole cohort. 14 Based on these studies, it is difficult to determine which MPV level is beneficial for the organism and what mechanisms determine the impact of MPV on cancer prognosis. Platelets act as a crucial modulator in tumor development, tumor cell growth, angiogenesis, and metastasis.…”

The prognostic value of mean platelet volume in cancer patients

“…In these diseases, elevated MPV was associated with worse clinical outcome, including lower platelets (p = 0.016), higher white blood cells (p = 0.015), higher percentage of circulatory blasts (p = 0.009), higher lactate dehydrogenase (p = 0.011), larger spleen size (p = 0.014), and higher Dynamic International Prognostic Score (DIPS) category (p = 0.027). Higher MPV was univariately associated with inferior OS in the whole cohort (HR = 3.82, p = 0.006) [34].…”

“…34 fL, p = 0.002). Moreover, high MPV levels significantly correlated with clinicopathologic parameters, such as distant metastasis (p = 0.039), primary tumor size (p = 0.042), and the tumor-nodemetastasis (TNM) stages (p = 0.035).…”