Related Experiment Video
Updated: Jul 17, 2026
Identifying Bone Marrow Microenvironmental Populations in Myelodysplastic Syndrome and Acute Myeloid Leukemia
Published on: November 10, 2023
Circulating microemboli in patients with myeloproliferative disorders
C A Weber1, A C Matzdorff, T Gerriets
1Department of Neurology, Justus-Liebig University, Giessen, Germany.
Abstract:
Myeloproliferative disorders (MPD) are associated with an increased risk for thrombembolic events. In this study, we examined the prognostic value of transcranial Doppler (TCD) microemboli detection regarding clinical events and correlated TCD findings with results of blood cell counts and platelet flow cytometry to gain insight into the composition of circulating microemboli in these patients. In a cohort of 42 patients with MPD TCD microemboli detection was performed on a single occasion and correlated with thrombembolic events during a prospective follow up of 29.7 +/- 7.3 month. In all patients, a complete blood count and in 17 patients platelet flow cytometry were performed on the day of the TCD examination. Microembolic signals (MES) were recorded in 15 (35.7%) patients, however, without any correlation with the type of MPD, blood cell counts, or thrombembolic events [9 (21.4%)]. MES positive and negative patients did not differ regarding the levels of activated platelets, platelet microaggregates, or microparticles. We found a strong trend for higher rates of platelet-neutrophil conjugates in MES positive patients (P = 0.09). Detection of MES by TCD on a single occasion in MPD patients has only limited prognostic value. MES do not correlate with the type of MPD, nor blood cell counts. Flow cytometry suggests that MES in MPD may consist of platelet-neutrophil aggregates.
Insights
Transcranial Doppler (TCD) detection of microembolic signals (MES) has limited prognostic value for predicting thrombembolic events in myeloproliferative disorders (MPD). Microemboli in MPD may involve platelet-neutrophil aggregates.
Area of Science:
- Hematology
- Neurology
- Vascular Medicine
Background:
- Myeloproliferative disorders (MPD) significantly increase the risk of thrombembolic events.
- Transcranial Doppler (TCD) is used to detect microemboli, but its prognostic value in MPD is not fully understood.
Purpose of the Study:
- To evaluate the prognostic significance of TCD-detected microemboli for clinical events in MPD patients.
- To correlate TCD findings with blood cell counts and platelet flow cytometry to understand microemboli composition.
Main Methods:
- A cohort of 42 MPD patients underwent a single TCD microemboli detection session.
- Prospective follow-up assessed thrombembolic events over approximately 30 months.
- Complete blood counts and platelet flow cytometry were performed concurrently.
Main Results:
- Microembolic signals (MES) were detected in 35.7% of patients but did not correlate with MPD type, blood counts, or thrombembolic events (21.4%).
- No significant differences in platelet activation markers were observed between MES-positive and negative groups.
- A trend towards higher platelet-neutrophil conjugates was noted in MES-positive patients (P=0.09).
Conclusions:
- Single-occasion TCD microemboli detection offers limited prognostic value in MPD.
- MES in MPD do not correlate with disease type or blood cell counts.
- Flow cytometry suggests MES may comprise platelet-neutrophil aggregates in MPD.
