Increased plasma thrombopoietin levels in patients with myelodysplastic syndrome: a reliable marker for a benign subset of bone marrow failure

Abstract

ARTICLES 901 Myelodysplastic SyndromesAlthough myelodysplastic syndromes are heterogeneous disorders comprising a benign subset of bone marrow failure similar to aplastic anemia, no laboratory test has been established to distinguish it from bone marrow failures that can evolve into acute myeloid leukemia. Plasma thrombopoietin levels were measured in 120 patients who had myelodysplastic syndrome with thrombocytopenia (< 100 x 10 9 /L) to determine any correlation to markers associated with immune pathophysiology and outcome. Thrombopoietin levels were consistently low for patients with refractory anemia with excess of blasts, while patients with other myelodysplatic syndrome subsets had more variable results. Patients with thrombopoietin levels of 320 pg/mL and over had increased glycosylphosphatidylinositol-anchored protein-deficient blood cells (49.1% vs. 0%), were more likely to have a low International Prognostic Scoring System (IPSS) score (≤1.0, 100% vs. 65.5%), a higher response rate to immunosuppressive therapy (84.2% vs. 14.3%), and a better 5-year progression-free survival rate (94.1% vs. 63.6% for refractory cytopenia with unilineage dysplasia; 100.0% vs. 44.4% for refractory cytopenia with multilineage dysplasia). In conclusion, increased plasma thrombopoietin levels were associated with a favorable prognosis of bone marrow failure and could, therefore, represent a reliable marker for a benign subset of myelodysplastic syndrome. Increased plasma thrombopoietin levels in patients with

A Cytokine‐Based Diagnostic Program in Pediatric Aplastic Anemia and Hypocellular Refractory Cytopenia of Childhood

“…Previous studies on adults reported higher levels of TPO in patients with AA than in patients with MDS . Additionally, our study revealed higher levels of TPO in patients with AA than in patients with hypocellular RCC.…”

“…TPO has been identified as a hematopoietic growth factor that regulates the production of megakaryocytes and platelets . High TPO levels have been observed in patients with AA, and these abnormal levels correlate with disease severity …”

“…TPO has been identified as a hematopoietic growth factor that regulates the production of megakaryocytes and platelets. [10] High TPO levels have been observed in patients with AA, [4,11] and these abnormal levels correlate with disease severity. [12,13] IL-17, a proinflammatory cytokine that is primarily secreted by CD4 + T helper type 17 cells (Th17 cells), links innate and adaptive immunity and has been shown to play an important role in several autoimmune diseases.…”

Border between aplastic anemia and myelodysplastic syndrome

“…However, it is difficult to determine the cellularity of megakaryocytes in patients with BM failure, as a BM biopsy specimen taken from an iliac bone site does not accurately represent the number of megakaryocytes in the BM of whole body. We hypothesized that plasma TPO levels may serve as a surrogate marker for the number of megakaryocytes [11], and measured TPO levels in a large number of patients with thrombocytopenia [12]. Similar to the findings from previous studies [13,14], TPO levels in patients with AA were noticeably higher than those in patients with ITP or refractory anemia with excess of blasts (RAEB).…”

Recombinant human thrombopoietin promotes platelet engraftment after haploidentical hematopoietic stem cell transplantation: a prospective randomized controlled trial

“…Consistent with the mean baseline serum TPO level of 0.77±0.62 ng/mL reported by Wolff et al [30], we found a value of 553.9±518.1 pg/mL before transplantation. The adverse events were defined using the Common Terminology Using the same assay as that used in our study, Seiki et al [31] showed that the plasma TPO level of healthy individuals was 54.5±21.1 pg/mL, which was significantly lower than that of transplant patients. Therefore, high TPO levels before transplantation might be a compensatory reaction.…”