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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
Published on: May 23, 2025
Global coagulation in myeloproliferative neoplasms
Armando Tripodi1, Veena Chantarangkul, Francesca Gianniello
1Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Pace 9, 20122, Milan, Italy, armando.tripodi@unimi.it.
Annals of Hematology
|July 4, 2013
Summary
Patients with myeloproliferative neoplasms (MPN) have a procoagulant imbalance detectable by thrombin generation and thromboelastometry. These global coagulation tests may help assess thrombosis risk and treatment efficacy in MPN patients.
Area of Science:
- Hematology
- Thrombosis Research
- Clinical Coagulation
Background:
- Patients with myeloproliferative neoplasms (MPN) have an increased risk of thrombosis.
- Traditional coagulation tests often fail to detect abnormalities in MPN patients.
- Global coagulation tests may better represent the procoagulant balance in MPN.
Purpose of the Study:
- To investigate if thrombin generation and thromboelastometry can detect procoagulant imbalance in MPN patients.
- To assess the correlation of these global tests with clinical parameters and treatment in MPN.
Main Methods:
- Measured endogenous thrombin potential (ETP) in platelet-rich plasma (PRP) with and without thrombomodulin in 111 MPN patients and 89 controls.
- Assessed thromboelastometry parameters (clot formation time - CFT, maximal clot firmness - MCF) in whole blood.
- Correlated ETP ratios, CFT, and MCF with platelet counts, anticoagulant levels, and hydroxyurea treatment.
Main Results:
- MPN patients exhibited higher ETP ratios and shorter CFT/greater MCF compared to controls.
- ETP ratios correlated positively with platelet counts and inversely with free protein S, protein C, and antithrombin levels.
- Hydroxyurea treatment was associated with lower ETP ratios.
Conclusions:
- MPN patients demonstrate a detectable procoagulant imbalance using thrombin generation and thromboelastometry.
- These global coagulation assays may be valuable tools in clinical trials for evaluating thrombosis risk and therapeutic strategies in MPN.
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