The management of thrombocytosis

Kutti, Jack

doi:10.1111/j.1600-0609.1990.tb00355.x

Cited by 39 publications

(4 citation statements)

References 78 publications

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“…The evaluation of spleen size is essential for the diagnosis of PV according to the criteria established by the PVSG (1). It also appears that the evaluation of the size of the spleen in chronic myeloproliferative disorders should preferentially be carried out using gamma camera scintigraphy (14). The assessment of spleen size using this technique could also be important in the discrimination between PV and absolute erythrocytosis other than PV, as well as between PV and pseudopolycythaemia.…”

Section: Discussionmentioning

confidence: 99%

Assessment of spleen size using gamma camera scintigraphy in newly diagnosed patients with essential thrombocythaemia and polycythaemia vera

Carneskog

Wadenvik

Fjälling

et al. 1996

European J of Haematology

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By using gamma camera imaging the spleen size was assessed in 18 consecutive patients with essential thrombocythaemia (ET) and in 18 consecutive patients with polycythaemia vera (PV). All ET and PV patients were newly diagnosed and had not received any myelosuppressive therapy prior to study. The spleen areas in both posterior and left lateral projections were determined. Eighteen consecutive patients with idiopathic thrombocytopenic purpura (ITP) served as a control group since by definition they do not present with splenic enlargement; in these latter subjects the mean posterior and left lateral splenic areas were almost identical (48 ± 15 and 47 ± 17 cm2, respectively). In comparison with this control group patients with ET and PV had significantly larger spleens. In both ET and in PV patients the left lateral spleen scan area exceeded the posterior one. Patients with PV had larger splenic areas in both projections than did patients with ET, but the differences were not statistically significant. Compared to the ITP patients it was found that at least 50% of the ET patients and at least 61% of the PV patients at diagnosis presented with splenomegaly.

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Section: Discussionmentioning

confidence: 99%

Assessment of spleen size using gamma camera scintigraphy in newly diagnosed patients with essential thrombocythaemia and polycythaemia vera

Carneskog

Wadenvik

Fjälling

et al. 1996

European J of Haematology

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“…PV and ET on one hand and CML on the other hand. Indeed, in contrast to subjects with RT, haemorrhage and thrombosis are major causes of morbidity and mortality in PV and ET (20,21); these considerations particularly apply to patients with ET who in addition frequently manifest microvascular disturbances (20). Further, since automated cell counters steadily reveal an increasing number of patients with thrombocytosis there is an increasing need for rapid distinction between myeloproliferative and reactive thrombocytosis.…”

Section: Discussionmentioning

confidence: 99%

“…In ET the peripheral platelet count is always highly elevated (17); in PV as well as in CML the peripheral platelet count is frequently elevated and may well reach counts greater than those encountered in ET (18,19). The differential diagnosis between myeloproliferative thrombocythaemia and states of reactive thrombocytosis (RT) may sometimes be intriguing (20,21). Recent evidence suggests that MK ploidy determination could be useful in distinguishing between these 2 states (20,22).…”

Section: Introductionmentioning

confidence: 99%

“…The differential diagnosis between myeloproliferative thrombocythaemia and states of reactive thrombocytosis (RT) may sometimes be intriguing (20,21). Recent evidence suggests that MK ploidy determination could be useful in distinguishing between these 2 states (20,22). It was the aim of the present work to investigate whether the 2-colour flow cytometry could be useful in the above differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Flow cytometric analysis of megakaryocyte ploidy in chronic myeloproliferative disorders and reactive thrombocytosis

Jacobsson¹,

Carneskog²,

Ridell

et al. 1996

European J of Haematology

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Megakaryocyte (MK) ploidy patterns were analysed by flow cytometry in 29 newly diagnosed and previously untreated patients with chronic myeloproliferative disorders (MPD) and concomitant thrombocytosis, in 9 patients with reactive thrombocytosis (RT) and in 12 healthy individuals. Unfractionated bone marrow from routine aspirates was used. MKs were identified with a fluorescein labelled monoclonal antibody specific for glycoprotein IIIa (GPIIIa) and DNA was stained with propidium iodide. For the 12 healthy volunteers the mean modal ploidy number was 16 N; the 9 patients with RT displayed an identical MK ploidy pattern. The frequency of MKs with a ploidy 232 N was 45% among the patients with essential thrombocythaemia (ET) compared to 32% among the healthy volunteers (p

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Thrombotic complications in essential thrombocythemia with relatively low platelet counts

et al. 1997

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Essential thrombocythemia (ET) is often associated with thrombotic and hemorrhagic complications, mostly at platelet counts exceeding 600 x 10(9)/L. There are, however, a few reports of such complications in ET at considerably lower platelet levels and the therapeutic approach to affected patients with relatively low platelet counts is still controversial. In the present study, the first to directly address the issue of hemostatic manifestations at relatively low platelet counts, we have determined the lowest platelet counts associated with such manifestations in 56 consecutive ET patients. Clinical manifestations related to ET were recorded in 46 (82%) patients. Of the symptomatic patients, 32 (70%) had symptoms at platelet counts lower than 600 x 10(9)/L, 23 (50%) at counts lower than 500 x 10(9)/L, 10 (22%) at counts lower than 400 x 10(9)/L, and 6 patients (13%) at platelet counts as low as 300-350 x 10(9)/L. Severe complications occurred at platelet counts lower than 600 x 10(9)/L in 10 patients (22%), lower than 500 x 10(9)/L in 7 (15%), and at lower than 400 x 10(9)/L in 2 (4%). Thrombotic neurologic symptoms were the most common (31 patients, 67%), followed by peripheral vascular symptoms (17 patients, 37%); hemorrhagic complications were relatively rare (3 patients, 7%). In most cases, cessation or improvement of clinical manifestations was observed only after further reduction in platelet counts. In conclusion, thrombotic manifestations, including severe ones, are not uncommon in ET at relatively low platelet counts. We recommend that symptomatic patients with relatively low platelet counts be treated and the platelet counts further reduced well into the lower normal range.

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The management of thrombocytosis

Cited by 39 publications

References 78 publications

Assessment of spleen size using gamma camera scintigraphy in newly diagnosed patients with essential thrombocythaemia and polycythaemia vera

Assessment of spleen size using gamma camera scintigraphy in newly diagnosed patients with essential thrombocythaemia and polycythaemia vera

Flow cytometric analysis of megakaryocyte ploidy in chronic myeloproliferative disorders and reactive thrombocytosis

Thrombotic complications in essential thrombocythemia with relatively low platelet counts

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