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Thrombocytosis and Thrombosis: Is There Really a Correlation?
Carlos Galvez1, Brady L Stein2,3
1Division of Hematology-Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair, Suit 850, Chicago, IL, 60611, USA.
Current Hematologic Malignancy Reports
|May 14, 2020
Summary
Thrombocytosis in myeloproliferative neoplasms (MPN) does not increase thrombosis risk. Instead, high platelet counts are linked to a higher risk of bleeding, a significant clinical finding.
Area of Science:
- Hematology
- Oncology
- Internal Medicine
Background:
- Thrombocytosis is a hallmark of myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET) and polycythemia vera (PV).
- A common clinical belief links thrombocytosis to an increased risk of thrombosis in MPN patients.
- This review critically examines the evidence supporting this association.
Observation:
- Retrospective and prospective studies do not support a correlation between thrombocytosis and thrombosis risk in ET and PV.
- Extreme thrombocytosis is paradoxically associated with an increased risk of hemorrhagic events.
Findings:
- The quantity of platelets (thrombocytosis) shows a weak association with thrombosis risk in MPNs.
- Qualitative platelet abnormalities may play a role in thrombosis pathogenesis.
- Thrombosis risk in MPNs is multifactorial, extending beyond platelet count.
Implications:
- Clinical management of MPNs should reconsider the role of thrombocytosis in thrombosis risk assessment.
- Focus may need to shift towards identifying other risk factors for thrombosis in MPN.
- The paradoxical link between high platelet counts and bleeding risk requires further investigation and clinical attention.
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