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Abnormal platelet function in myeloproliferative disorders.

C C Waddell, J A Brown, Y A Repinecz

    Archives of Pathology & Laboratory Medicine
    |August 1, 1981
    PubMed
    Summary
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    Platelet aggregation abnormalities are common in myeloproliferative disorders, persisting even with normal platelet counts. Some patients showed increased circulating platelet aggregates, with antiplatelet therapy potentially improving outcomes.

    Area of Science:

    • Hematology
    • Oncology
    • Vascular Biology

    Background:

    • Myeloproliferative disorders (MPDs) are a group of clonal hematopoietic stem cell diseases.
    • Thrombocytosis, an elevated platelet count, is a common feature of MPDs.
    • Platelet function and circulating platelet aggregates (CPAs) in MPDs require further investigation.

    Purpose of the Study:

    • To evaluate platelet aggregation and CPA levels in patients with MPDs.
    • To determine correlations between platelet abnormalities, thrombocytosis, and clinical bleeding or vascular events.
    • To assess the impact of antiplatelet therapy on CPA levels and clinical symptoms.

    Main Methods:

    • Assessed platelet aggregation responses to various agonists (epinephrine, adenosine diphosphate, collagen) in 18 MPD patients.

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  • Measured circulating platelet aggregates (CPAs) in patients.
  • Correlated laboratory findings with clinical history of bleeding and vascular events.
  • Monitored patients undergoing treatment, including antiplatelet therapy.

    • Main Results:

    • No specific platelet aggregation patterns were universally detected.
    • Abnormal aggregation occurred in a significant proportion of patients: 11/18 with epinephrine, 9/18 with adenosine diphosphate, and 7/18 with collagen.
    • Bleeding episodes did not definitively correlate with abnormal aggregation, except in one case with severe thrombocytosis.
    • Aggregation defects persisted despite platelet count reduction.
    • Increased CPAs with normal aggregation were observed in two patients, one with transient ischemic attacks that resolved with antiplatelet therapy and normalization of CPA index.
    • Two patients with peripheral vascular disease showed no increased CPAs, but one improved with antiplatelet therapy.

    Conclusions:

    • Platelet aggregation defects are frequent in MPDs and can persist independently of platelet count.
    • Circulating platelet aggregates may be elevated in some MPD patients and could be a marker for thrombotic risk.
    • Antiplatelet therapy may offer clinical benefits in MPD patients with vascular complications, potentially linked to CPA reduction.