LOW PLATELETCRIT IS ASSOCIATED WITH REDUCED PROGRESSION – FREE AND OVERALL SURVIVAL IN CHRONIC LYMPHOCYTIC LEUKEMIA
Plateletcrit and Chronic Lymphocytic Leukemia
Abstract
BACKGROUD
Alterations of plateletcrit and mean platelet volume (MPV) and pathogenesis of chronic lymphocytic leukemia (CLL) have been linked to various inflammatory disorders. The prognostic impact of plateletcrit and MPV were evaluated.
METHODSMPV and plateletcrit levels of both CLL and control group were compared and then in CLL patients, additional diseases, leukocyte count, platelet count, lactate dehydrogenase, Rai stage, progression-free and overall survival, mutations, if any, and chemotherapy, if any, were recorded. Then, the relationship between MPV and plateletcrit values and these parameters were evaluated in CLL patients.
RESULTSPlatelet and plateletcrit values were found to be significantly lower in CLL patients than the control group (p<0.001) for both. Plateletcrit and MPV values of patients who did not receive chemotherapy were higher than those who received chemotherapy (p=0.03, p=0.02, respectively). Being over 75 years old, plateletcrit value less than 0.1565 %, platelet level below 175x 109/L, and leukocyte count greater than 53.5 x 109/L was found to significantly reduce overall survival. Male gender, each stage increase, plateletcrit less than 0.1565 % and leukocyte count greater than 53.5 x 109/L was related to reduced treatment-free survival in CLL patients.
CONCLUSIONPlateletcrit is a viable prognostic marker for defining both treatment free and overall survival.
References
2- International CLL-IPI working group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol. 2016 Jun; 17(6):779-790. doi: 10.1016/S1470-2045(16)30029-8. Epub 2016 May 13. PMID: 27185642.
3- O'Brien S, Furman RR, Coutre SE, Sharman JP, Burger JA, Blum KA, et al. Ibrutinib as initial therapy for elderly patients with chronic lymphocytic leukaemia or small lymphocytic lymphoma: an open-label, multicentre, phase 1b/2 trial. Lancet Oncol. 2014 Jan;15(1):48-58. doi: 10.1016/S1470-2045(13)70513-8. Epub 2013 Dec 10. PMID: 24332241; PMCID: PMC4134524.
4- Roberts AW, Davids MS, Pagel JM, Kahl BS, Puvvada SD, Gerecitano JF, et al. Targeting BCL2 with Venetoclax in Relapsed Chronic Lymphocytic Leukemia. N Engl J Med. 2016 Jan 28;374(4):311-22. doi: 10.1056/NEJMoa1513257. Epub 2015 Dec 6. PMID: 26639348; PMCID: PMC7107002.
5- Linke B, Schreiber Y, Picard-Willems B, Slattery P, Nüsing RM, Harder S, et al. Activated Platelets Induce an Anti-Inflammatory Response of Monocytes/Macrophages through Cross-Regulation of PGE2 and Cytokines. Mediators Inflamm. 2017;2017:1463216. doi: 10.1155/2017/1463216. Epub 2017 May 16. PMID: 28592915; PMCID: PMC5448075.
6- Sikora, J., Kostka, B. “Blood platelets as pharmacological model,” Postępy Biologii Komórki, vol. 3, no. 32, pp. 561– 569, 2005.
7- Kabasakal EA, Ergene U, Ozlu C. Normal complete blood count reference intervals in the Turkish population: a prospective study. Hematol Transfus Int J. 2018;6(4):135‒139.
8- Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019 Apr 17; 2019:9213074. doi: 10.1155/2019/9213074. PMID: 31148950; PMCID: PMC6501263.
9- Kaushansky K. The molecular mechanisms that control thrombopoiesis. J Clin Invest. 2005 Dec;115(12):3339-47. doi: 10.1172/JCI26674. PMID: 16322778; PMCID: PMC1297257.
10- Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J. 2001 Sep;22(17):1561-71. doi: 10.1053/euhj.2000.2515. PMID: 11492985.
11- Afsar N, Afroze IA, Tahniath H, Abid Z. Role of mean platelet volume as an adjunct in evaluation of acute inflammation. Annals of Pathology and Laboratory Medicine, vol. 4, no. 4, pp. A466–A469, 2017.
12- Sahin F, Aslan AF. Relationship between Inflammatory and Biological Markers and Lung Cancer. J Clin Med. 2018 Jun 25;7(7):160. doi: 10.3390/jcm7070160. PMID: 29941786; PMCID: PMC6069225.
13- Hur JY, Lee HY, Chang HJ, Choi CW, Kim DH, Eo WK. Preoperative plateletcrit is a Prognostic Biomarker for Survival in Patients with Non-Small Cell Lung Cancer. J Cancer. 2020 Feb 25;11(10):2800-2807. doi: 10.7150/jca.41122. PMID: 32226498; PMCID: PMC7086273.
14- Zhu X, Cao Y, Lu P, Kang Y, Lin Z, Hao T, et al. Evaluation of platelet indices as diagnostic biomarkers for colorectal cancer. Sci Rep. 2018 Aug 7;8(1):11814. doi: 10.1038/s41598-018-29293-x. PMID: 30087357; PMCID: PMC6081379.
15- Karateke A, Kaplanoglu M, Baloglu A. Relations of Platelet Indices with Endometrial Hyperplasia and Endometrial Cancer. Asian Pac J Cancer Prev. 2015;16(12):4905-8. doi: 10.7314/apjcp.2015.16.12.4905. PMID: 26163613.
16- Oncel M, Kiyici A, Oncel M, Sunam GS, Sahin E, Adam B. Evaluation of Platelet Indices in Lung Cancer Patients. Asian Pac J Cancer Prev. 2015;16(17):7599-602. doi: 10.7314/apjcp.2015.16.17.7599. PMID: 26625768.
17- Li H, Wang Y, Liu Z, Yuan Y, Huang W, Zhang N, et al. Lack of association between platelet indices and disease stage in osteosarcoma at diagnosis. PLoS One. 2017 Apr 6;12(4):e0174668. doi: 10.1371/journal.pone.0174668. PMID: 28384168; PMCID: PMC5383043.
18- Tang J, Gao X, Zhi M, Zhou HM, Zhang M, Chen HW, et al. Plateletcrit: a sensitive biomarker for evaluating disease activity in Crohn's disease with low hs-CRP. J Dig Dis. 2015 Mar;16(3):118-24. doi: 10.1111/1751-2980.12225. PMID: 25565427.
19- Mohamed AB, Elnady HM, Alhewaig HK, Moslem HH, Khodery A. The mean platelet volume and plateletcrit as predictors of short-term outcome of acute ischemic stroke. Egypt J Neurol Psychiatr Neurosurg. 2019;55(1):4. doi: 10.1186/s41983-018-0035-x. Epub 2019 Jan 8. PMID: 30686914; PMCID: PMC6325094.
20- Coskun ME, Alidris A, Temel MT, Akbayram S, Hizli S. Plateletcrit: A possible biomarker of inflammation in hepatitis A infection. Niger J Clin Pract. 2019 May;22(5):727-730. doi: 10.4103/njcp.njcp_331_18. PMID: 31089030.
21- Gul M, Uyarel H, Akgul O, Akkaya E, Surgit O, Cakmak HA, et al. Long-term prognostic significance of admission plateletcrit values in patients with non-ST elevation myocardial infarction. Blood Coagul Fibrinolysis. 2016 Sep;27(6):696-701. doi: 10.1097/MBC.0000000000000484. PMID: 26820228.
22- Chen LS, Balakrishnan K, Gandhi V. Inflammation and survival pathways: chronic lymphocytic leukemia as a model system. Biochem Pharmacol. 2010 Dec 15;80(12):1936-45. doi: 10.1016/j.bcp.2010.07.039. Epub 2010 Aug 7. PMID: 20696142; PMCID: PMC3749885.
23- Balkwill F. Tumour necrosis factor and cancer. Nat Rev Cancer. 2009 May;9(5):361-71. doi: 10.1038/nrc2628. Epub 2009 Apr 3. PMID: 19343034.
24- Costinean S, Zanesi N, Pekarsky Y, Tili E, Volinia S, Heerema N, et al. Pre-B cell proliferation and lymphoblastic leukemia/high-grade lymphoma in E(mu)-miR155 transgenic mice. Proc Natl Acad Sci U S A. 2006 May 2;103(18):7024-9. doi: 10.1073/pnas.0602266103. Epub 2006 Apr 25. PMID: 16641092; PMCID: PMC1459012.
25- Mosser DM, Zhang X. Interleukin-10: new perspectives on an old cytokine. Immunol Rev. 2008 Dec;226:205-18. doi: 10.1111/j.1600-065X.2008.00706.x. PMID: 19161426; PMCID: PMC2724982.
26- Lai R, O'Brien S, Maushouri T, Rogers A, Kantarjian H, Keating M, et al. Prognostic value of plasma interleukin-6 levels in patients with chronic lymphocytic leukemia. Cancer. 2002 Sep 1;95(5):1071-5. doi: 10.1002/cncr.10772. PMID: 12209693.
27- Löffler D, Brocke-Heidrich K, Pfeifer G, Stocsits C, Hackermüller J, Kretzschmar AK, et al. Interleukin-6 dependent survival of multiple myeloma cells involves the Stat3-mediated induction of microRNA-21 through a highly conserved enhancer. Blood. 2007 Aug 15;110(4):1330-3. doi: 10.1182/blood-2007-03-081133. Epub 2007 May 11. PMID: 17496199.
28- Masternak M, Puła B, Knap J, Waszczuk-Gajda A, Drozd-Sokołowska J, Wdowiak K, et al. Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia. Cancer Manag Res. 2020 Oct 12;12:9977-9985. doi: 10.2147/CMAR.S246385. PMID: 33116854; PMCID: PMC7567945.
29- Zhou S, Ma Y, Shi Y, Tang L, Zheng Z, Fang F, et al. Mean platelet volume predicts prognosis in patients with diffuse large B-cell lymphoma. Hematol Oncol. 2018 Feb;36(1):104-109. doi: 10.1002/hon.2467. Epub 2017 Jul 23. PMID: 28736928.
30- Rupa-Matysek J, Gil L, Kroll-Balcerzak R, Barańska M, Komarnicki M. Mean platelet volume as a predictive marker for venous thromboembolism and mortality in patients treated for diffuse large B-cell lymphoma. Hematol Oncol. 2017 Dec;35(4):456-464. doi: 10.1002/hon.2321. Epub 2016 Jul 5. PMID: 27377517.
Copyright (c) 2022 Demircan Ozbalci, Emine Guchan Alanoglu, Eda Findos, Hande Nur Eroglu
This work is licensed under a Creative Commons Attribution 4.0 International License.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.