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

Abstract

Purpose: Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation. Patients and Methods: The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann-Whitney, Kruskal-Wallis, Kaplan-Meier, chi-squared, log-rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data. Results: The receiver operating characteristic curve analysis was performed to identify optimal cutoff value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cutoff value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259). Conclusion: Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.

Outcome of SARS-CoV-2-Infected Polish Patients with Chronic Lymphocytic Leukemia

“…Interestingly we found that low platelet counts were associated with poor outcome in the whole and hospitalized patient cohort. Platelets have been discussed to modify course of the disease in various cancers, including CLL [20,21]. It was shown that thrombocytopenia was associated with poor outcome of COVID-19 patients in intensive care units [22].…”

The effect of Bruton's tyrosine kinase inhibitor ibrutinib on atherothrombus formation under stenotic flow conditions

“…No studies have reported a link between PDW and ibrutinib treatment or bleeding events. Furthermore, MPV is not associated with ibrutinib therapy complications, including atrial fibrillation and bleeding [47]. All ibrutinib treated patients but one had a normal platelet count, implicating that the effect observed due to ibrutinib treatment is not due to low platelet count but due to a potential role of ibrutinib on platelet function.…”

Low plateletcrit is associated with reduced progression: Free and overall survival in chronic lymphocytic leukemia

“…In chronic inflammation, large platelets were found to be released from bone marrow induced by pro-inflammatory cytokines, then later, these platelets were depleted on ongoing inflammation and a significant drop on MPV levels could be seen in patients with chronic inflammation [10] [11] . Also, chronic proinflammatory cytokine release could lead to release of small therefore low-MPV platelets so, MPV and PCT levels could be found to be decreased [28] . These mechanisms should be responsible for low PCT associated poor outcome in CLL.…”

“…In diffuse large B cell lymphoma, two studies have shown that low MPV was associated with worse prognosis [29] [30] . Masternak et al, found that low MPV was associated with adverse outcome in CLL; patients who need treatment had lower MPV levels compared to patients who did not need any [28] . Also, low MPV was associated with shorter time for treatment and a tendency to lower MPV levels was seen as Rai stage advances besides from stage IV in this study.…”