Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/17963
Title: An evaluation of global coagulation assays in myeloproliferative neoplasm.
Authors: Lim, Hui Y;Ng, Cheryl;Rigano, Joseph;Tacey, Mark;Donnan, Geoffrey;Nandurkar, Harshal;Ho, Prahlad
Affiliation: Department of Haematology, Northern Hospital
Austin Pathology, Austin Health, Heidelberg, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
Australian Centre for Blood Diseases, Monash University
Issue Date: Apr-2018
Citation: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis 2018; 29(3): 300-306
Abstract: Myeloproliferative neoplasms (MPN) are independent risks for thrombotic events. Routine laboratory tests are inadequate to evaluate the underlying procoagulant state. Global coagulation assays such as thromboelastography, thrombin and fibrin generation may provide better assessment of coagulation activation and thereby of thrombosis risk. Participants with MPN were recruited. Thromboelastography was performed on citrated whole blood while thrombin generation using calibrated automated thrombogram, fibrin generation using overall haemostatic potential assays and P-selectin were quantified on platelet-poor plasma. Thirty-eight MPN patients (median age: 65 years) were recruited. There were 26 patients with essential thrombocythemia (68.4%), eight polycythemia vera (20.5%), three primary myelofibrosis and one MPN, unclassifiable. Compared with normal controls, there was no difference in maximum amplitude although lysis time (LY30) was significantly higher (2.9 vs. 0.6%, adjusted P < 0.01) using thromboelastography. Calibrated automated thrombogram showed higher thrombin peak (260.8 vs. 222.6 nmol/l; P < 0.01) and velocity index (91.1 vs. 65.0 nmol/l/min; P < 0.01) with comparable endogenous thrombin potential. Fibrin generation parameters were significantly reduced with preserved overall fibrinolytic potential, whereas P-selectin was markedly increased (108.9 vs. 49.3 ng/ml, P < 0.01). This study demonstrated unique differences between MPN population and normal controls using a combination of global coagulation assays. The presence of high lysis time (LY30) and reduced fibrin generation in MPN patients were contradictory to the prothrombotic nature and may represent a compensatory effort to achieve equilibrium within the Virchow's triad. Both markers may be important prognostic indicators of thrombosis in MPN and further prospective studies to confirm these findings are proposed.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17963
DOI: 10.1097/MBC.0000000000000724
ORCID: 0000-0001-6324-3403
PubMed URL: 29538005
Type: Journal Article
Appears in Collections:Journal articles

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