High level of circulat ing microparticles in patients with BCR/ ABL negative myeloproliferative neoplasm - A pilot study

Abstract

Background: Microparticles (MPs) are small (0.1- 1 µm) cell-derived vesicles released dur - ing activation or apoptosis, with a surface-exposed phosphatidylserine along with antigens indicat ing the cellular origin. The level of MPs is known to be elevated in thromboembolic dis eases and malignancies; it is believed that MPs are not only amplify ing but can also initiate the thrombogenesis processes. BCR/ ABL negative myeloproliferative neoplasms (MPNs) are clonal haematopoietic dis eases, which include polycythemia vera, essential thrombocythemia and primary myelofibrosis. One of the main problems of MPN patients is high risk and incidence of thrombosis which affect the survival, quality of life and life expectancy. Patients and methods: The clinical significance of circulat ing MPs was assessed in a group of 179 patients with BCR/ ABL-negative MPNs. Analysis of MPs was done us ing flow cytometry on 417 samples, and MPs procoagulation activity was performed us ing a functional assay called Zymuphen MP-activity (Hyphen Biomed, Neuville-sur-oise, France) on 274 samples. Results: Significantly higher absolute and relative count of platelet MPs was found in MPN patients when compared with healthy group, respectively (p = 0.001, p = 0.043). Erythrocyte MPs were also significantly higher in MPN patients than in the healthy group (p < 0.001). Procoagulation activity of MPs was as well significantly higher in patients compared to the control group (p < 0.001). Patients with primary myelofibrosis had decreased absolute and relative count of platelet MPs compared to polycythemia vera and essential thrombocythemia patients, respectively (p = 0.008, p = 0.014). Presence of JAK2V617F mutation was associated with higher absolute and relative count of platelet MPs, respectively (p = 0.045, p = 0.029). Conclusion: Although some literature data support the hypothesis of a direct relation between MPs and thrombotic events in MPN patients, further studies are needed to evaluate the clinical implication of MPs in the hypercoagulation state of MPN patients.