Serum Thrombopoietin Level in Various Hematological Diseases

Abstract

Abstract. To investigate the pathophysiological role of thrombopoietin (TPO) in thrombopoiesis, we measured its serum levels in 15 healthy individuals, 84 patients with various hematological diseases and 2 patients with liver cirrhosis using an enzyme immunoassay procedure. The TPO level was 0.84 ± 0.40 f mol/ml in normal individuals. TPO levels were considerably elevated in patients with myelosuppression after intensification chemotherapy of acute leukemia in complete remission (postchemotherapy group; n = 18; 18.46 ± 9.70 f mol/ml). When the data of normal individuals and the postchemotherapy group were combined, TPO levels were inversely correlated with the platelet count in this combined group. We compared these data of normal individuals and the postchemotherapy group with various hematological disease states. In aplastic anemia (n = 13; 16.03 ± 9.44 f mol/ml), acute lymphoblastic leukemia (n = 5; 10.36 ± 5.57 f mol/ml), malignant lymphoma (n = 6; 2.79 ± 2.27 f mol/ml), multiple myeloma (n = 3; 3.34 ± 0.20 f mol/ml) and chronic lymphocytic leukemia (n = 2; 1.71 ± 3.91 f mol/ml), the relationship of serum TPO levels and platelet counts was almost the same as in the combined group with normal individuals and the postchemotherapy group. However, the TPO levels were slightly higher in myeloproliferative disorders (n = 12; 1.99 ± 1.47 f mol/ml) and lower in acute myelogenous leukemia (n = 8; 2.27 ± 1.25 f mol/ml), hypoplastic leukemia (n = 3; 2.76 ± 2.23 f mol/ml), myelodysplastic syndrome (n = 2; 0.42 ± 0.60 f mol/ml), liver cirrhosis (n = 2; 1.50 ± 0.92 f mol/ml) and idiopathic thrombocytopenic purpura (n = 12; 2.08 ± 1.41 f mol/ml), when compared to the regression line for the combined group with normal individuals and postchemotherapy group. These findings suggest that TPO might play an important role in regulation of the platelet count in normal and pathological conditions.

Essential thrombocythemia after allogeneic bone marrow transplantation for chronic myelogenous leukemia

“…It has been proposed, based on TPO levels in patients with aplastic anemia and idiopathic thrombocytopenic purpura, that the serum TPO levels were inversely correlated with total platelet mass. 6 This case illustrates a dysregulation in the relationship between platelet mass and serum TPO levels, and is consistent with observations reported in patients with essential thrombocytopenia, 7,8 suggesting a neoplastic disorder driven by dysregulated TPO production. No relationship between TPO levels and the platelet count was observed in patients with other myeloproliferative disorders.…”

“…No relationship between TPO levels and the platelet count was observed in patients with other myeloproliferative disorders. 8 The origin of the neoplastic clone in post-transplant malignancies has been determined by different methods, including white blood cell isoenzyme polymorphisms, routine and multi-parameter fluorescence in situ hybridization (FISH) karyotypic analyses, 9 and DNA polymorphisms recognized by restriction endonuclease digestion and Southern blot hybridization or polymerase chain reaction analyses. 10 The identification of a highly polymorphic genetic locus in the human genome makes it possible to distinguish individual genotypes.…”

Prospective screening of 205 patients with ITP, including diagnosis, serological markers, and the relationship between platelet counts, endogenous thrombopoietin, and circulating antithrombopoietin antibodies

“…Serum concentrations of endogenous TPO (eTPO) reflect its constitutive production by the liver and its clearance through binding and internalization by Mpl, the TPO receptor found on the surfaces of platelets and megakaryocytes [10,11]. Several studies have reported increased amounts of eTPO in patients with thrombocytopenia secondary to aplastic anemia, amegakaryocytic thrombocytopenia, and myeloablative chemotherapy [12][13][14][15][16][17][18][19]. In contrast, eTPO levels are not increased in patients with ITP, despite the markedly reduced number of circulating platelets [14][15][16]20].…”

A Rare Case of Acute Myeloid Leukemia with a t(2;3) Chromosomal Translocation Characterized by Thrombophilia and Chemoresistance

“…Notably, anagrelide was effective, even though we detected a thrombopoietin serum concentration only marginally above normal. 6 Allogenic hematopoietic stem cell transplantation from his HLA-identical brother (10/10-Ag) was performed 60 days after diagnosis using FLAMI/RIC conditioning (fludarabine 30 mg/m 2 , days 1-4, cytarabine 2,000 mg/m 2 , days 1-4, mitoxantrone 10 mg/m 2 , days 1-4, total body irradiation 4 Gy, day 8, cyclophosphamide 60 mg/m 2 , days 9-10). Therapy associated complications included neutropenic fever, BK-virus associated cystitis and a severe mucositis (common toxicity criteria [CTC] grade III/IV).…”