Serum Erythropoietin and Thrombopoietin Levels in Patients with Essential Thrombocythaemia

Grießhammer, Martin; Kubanek, B; Beneke, Heimo; Heimpel, Hermann; Bangerter, Markus; Bergmann, Lothar; Schrezenmeier, Hubert

doi:10.3109/10428190009148401

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…Thus, approximately 50% of ET patients investigated at diagnosis or prior to the institution of any myelosuppressive treatment had subnormal plasma EPO concentration (Carneskog et al , 1998; Andréasson et al , 2000). Similar results have been reported by other investigators (Viala et al , 1993; Griesshammer et al , 2000; Messinezy et al , 2002).…”

Section: Discussionsupporting

confidence: 93%

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

et al. 2003

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Summary. Essential thrombocythaemia (ET) is a heterogeneous disorder with respect to plasma erythropoietin concentration at diagnosis and clonality of haematopoiesis. Polycythaemia rubra vera-1 (PRV-1) positivity, i.e. PRV-1 mRNA overexpression, is known to be present in the vast majority of patients with polycythaemia vera and also in some patients with ET. In the present study, PRV-1 expression was quantified by real-time polymerase chain reaction in 70 ET patients; 17 of them (24%) were found to be PRV-1 positive. Ten of the 17 PRV-1 positive ET patients had experienced thromboembolic complications compared with 14 of 53 PRV-1 negative patients, the difference between the two groups being statistically significant (P ¼ 0AE02). In addition, the frequency of total vascular complications, thromboembolic events and major bleedings, was significantly higher in the group of PRV-1 positive as compared with PRV-1 negative ET patients (P ¼ 0AE03). The time from diagnosis of ET to the requirement of plateletlowering therapy was significantly shorter in PRV-1 positive compared with PRV-1 negative ET patients (P ¼ 0AE014). It can be concluded that PRV-1 positive patients appear to suffer from a more aggressive disorder with increased risk for vascular complications and a greater need for plateletlowering therapy, compared with PRV-1 negative ET patients.

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Section: Discussionsupporting

confidence: 93%

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

et al. 2003

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“…The plasma EPO concentration is almost invariably subnormal in untreated and phlebotomy‐treated patients with PV (3, 21–23) and also in approximately 50% of untreated ET patients (3, 4, 24). In the present study the mean plasma EPO concentration for the IMF patients significantly exceeded the means for PV patients and control subjects ( P <0.05 for both groups), a finding obviously influenced by apparent differences in haemoglobin concentrations between the groups.…”

Section: Discussionmentioning

confidence: 99%

Patients with idiopathic myelofibrosis show increased CD34⁺ cell concentrations in peripheral blood compared to patients with polycythaemia vera and essential thrombocythaemia

Andréasson

Swolin

Kutti

2002

European J of Haematology

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The aim of the present work was to compare the results for some haematological variables in 12 patients with idiopathic myelofibrosis (IMF) with those of 21 patients with polycythaemia vera (PV), 22 patients with essential thrombocythaemia (ET) and 10 healthy control subjects. In each patient and control subject peripheral blood was used for analysis of flow cytometric measurement of CD34-positive (CD34+) cells, in vitro colony growth and plasma erythropoietin (EPO) concentration. The mean concentration of CD34+ cells in the IMF group was 568 +/- 686 x 10(3) mL, which significantly (P<0.001 for each group) exceeded the means in PV, ET and control groups ((10.2 +/- 32.0) x 10(3) mL, 3.0 +/- 3.7 x 10(3) mL and 1.9 +/- 0.8 x 10(3) mL, respectively). The mean number of EPO-independent erythroid colonies (EEC) was 110 +/- 215 colonies per 10(5) cells for the IMF patients. In comparison with the means for PV and ET patients (40 +/- 140 and 12 +/- 27 colonies per 10(5) cells, respectively) the difference did not reach statistical significance. The mean EEC for IMF patients was, however, significantly higher compared with the mean for the control subjects (P<0.05). The means for total erythroid colony growth with EPO added to the growth medium as well as for granulocyte-macrophage colony-forming units were significantly higher in the IMF group compared with the means for PV, ET and control groups (P<0.001 for each group). The mean plasma EPO was 204 +/- 290 IU/L in the patients with IMF compared with 6.6 +/- 7.9 IU/L in PV patients, 19.1 +/- 23.2 IU/L in ET and 10.3 +/- 7.8 IU/L in the control subjects. Due to considerable differences in haemoglobin concentrations no relevant conclusions could be drawn from the results for plasma EPO concentrations. Indeed, the majority of patients with IMF, PV and ET were on myelosuppressive treatment; additionally most PV patients received phlebotomy therapy. The results of the present study suggest that the circulating pool of stem cells and progenitor cells in peripheral blood is significantly increased in IMF patients compared with PV and ET patients as well as healthy control subjects. The most likely source for the elevated CD34+ cell concentration in peripheral blood is progenitor cells of extra-medullar origin.

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“…Likewise, TPO concentrations are often high in reactive thrombocytosis 13, 14, 18, 22. A few reports have described higher TPO levels in treated compared to untreated MPD patients 15, 17, 12. In some of these studies, an inverse relation between blood platelet counts and TPO was observed 16, 26 but just as often there was no correlation 13, 19.…”

Section: Introductionmentioning

confidence: 98%

TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders

Palmblad¹,

Björkholm²,

Kutti³

et al. 2008

Int. J. Med. Sci.

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Anagrelide is often used in the treatment of thrombocythemia in myeloproliferative disease (MPD), but information concerning effects of treatment on cytokines involved in regulation of blood platelet levels is limited. Here, we investigated serum levels of thrombopoietin (TPO) and soluble IL-6 receptor (sIL-6R) in relation to response to treatment with and plasma concentrations of anagrelide. Samples from 45 patients with thrombocythemia due to MPD (ET=31, PV=14), being treated with anagrelide for 6 months, were analyzed for TPO, sIL-6R and anagrelide levels. The mean baseline platelet count was 983x10 9 /L. A reduction of platelets to <600 in asymptomatic or <400 x 10 9 /L in symptomatic patients was defined as a complete remission (CR), a reduction with >50% of baseline as partial remission, and <50% reduction as failure. At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures. For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly. There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts. Thus, a pronounced increase of TPO levels after 6 months of anagrelide treatment indicated that this treatment affected a major regulatory mechanism for megakaryocyte and platelet formation in MPD.

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Serum Erythropoietin and Thrombopoietin Levels in Patients with Essential Thrombocythaemia

Cited by 14 publications

References 18 publications

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

Patients with idiopathic myelofibrosis show increased CD34⁺ cell concentrations in peripheral blood compared to patients with polycythaemia vera and essential thrombocythaemia

TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders

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Serum Erythropoietin and Thrombopoietin Levels in Patients with Essential Thrombocythaemia

Cited by 14 publications

References 18 publications

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

Increased risk for vascular complications in PRV‐1 positive patients with essential thrombocythaemia

Patients with idiopathic myelofibrosis show increased CD34+ cell concentrations in peripheral blood compared to patients with polycythaemia vera and essential thrombocythaemia

TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders

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Patients with idiopathic myelofibrosis show increased CD34⁺ cell concentrations in peripheral blood compared to patients with polycythaemia vera and essential thrombocythaemia