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Updated: Sep 22, 2026
Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
Published on: March 26, 2018
Elevated P-RBC complexes are associated with thrombotic risk and diagnostic potential in myeloproliferative
Xiaonan Niu1, Caihong Jia1, Yuefan Ma1
1Department of Blood Transfusion, Second Hospital of Shanxi Medical University Taiyuan 030001, Shanxi, China.
Background:
Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders characterized by excessive myeloid proliferation. The impaired clearance of senescent erythrocytes is a key pathological feature, yet its mechanisms remain unclear. Pro-phagocytic platelet-erythrocyte (P-RBC) complexes may represent a novel intercellular interaction involved in this process.
Objective:
To investigate the levels of P-RBC complexes in MPN patients, their association with clinical characteristics and thrombotic risk, and their potential diagnostic value.
Methods:
In this retrospective cohort study, 152 MPN patients (including polycythemia vera [PV], essential thrombocythemia [ET], and primary myelofibrosis [PMF]) and 152 healthy controls were enrolled. P-RBC complex levels in peripheral blood were measured using flow cytometry. Correlations with laboratory parameters, thrombotic events, and survival were analyzed.
Results:
P-RBC complex levels were significantly higher in MPN patients than in controls (2.76 ± 0.53% vs. 1.28 ± 0.37%, P < 0.001). Levels varied by subtype, with PMF patients showing the highest levels (3.28 ± 0.52%), followed by PV (2.76 ± 0.44%) and ET (2.49 ± 0.39%) (P < 0.001). P-RBC levels positively correlated with hemoglobin (r = 0.456), C-reactive protein (r = 0.291), and lactate dehydrogenase (r = 0.736) (all P < 0.001). Patients with thrombotic events had higher P-RBC levels than those without (3.04 ± 0.70% vs. 2.72 ± 0.48%, P = 0.009). Multivariate analysis identified P-RBC level as an independent risk factor for thrombosis (OR = 3.07, P = 0.012). Although survival was worse in the high-P-RBC group, the difference was not statistically significant (P = 0.194). ROC analysis showed excellent diagnostic performance for MPNs (AUC = 0.990), with 100.0% sensitivity and 91.4% specificity at a 1.80% cutoff.
Conclusion:
P-RBC complexes are significantly elevated in MPN patients and correlate with disease subtype, inflammation, and thrombotic risk. They represent a promising novel biomarker for MPN diagnosis and risk stratification.
