Uncontrolled thrombocytosis in chronic myeloproliferative disorders

Summary. A retrospective study was performed to examine the natural course of uncontrolled thrombocytosis associated with chronic myeloproliferative disorders. Thirty‐eight patients with polycythaemia rubra vera (PV), myelofibrosis/myeloid metaplasia (MM), chronic myelogenous leukaemia (CML) or essential thrombocythaemia (ET) had platelet counts greater than 1000 × 109/1 and were followed closely for a total of 246 patient years. Eleven of the patients experienced haemorrhagic episodes. Bleeding was twice as frequent in patients over 59 years old as in those younger and no bleeding occurred in those less than 51 years of age. There was no correlation between frequency of bleeding and extent of thrombocytosis. Bleeding events occurred concurrently with use of anti‐inflammatory agents in 32% of episodes. The gastrointestinal tract was the most frequent site. Documented thrombotic events occurred in three patients, two of whom had PV with haematocrits greater than 53%. This study suggests that the thrombocytosis of myeloproliferative processes may pose a less serious threat than originally thought and that aggressive lowering of the platelet count may not be indicated in all cases.

[1]  J. Goldberg,et al.  Increased incidence of acute leukemia in polycythemia vera associated with chlorambucil therapy. , 1981, The New England journal of medicine.

[2]  D. Goldfinger,et al.  Long‐Term Plateletpheresis in the Management of Primary Thrombocytosis , 1979, Transfusion.

[3]  R. Reiss,et al.  Therapeutic Plateletpheresis in Thombocythemia , 1979, Transfusion.

[4]  R. Russell,et al.  Cerebral blood-flow and viscosity in relative polycythaemia. , 1979, Lancet.

[5]  T. Pearson,et al.  VASCULAR OCCLUSIVE EPISODES AND VENOUS HÆMATOCRIT IN PRIMARY PROLIFERATIVE POLYCYTHÆMLX , 1978, The Lancet.

[6]  A. Schafer,et al.  Platelet resistance to prostaglandin D2 in patients with myeloproliferative disorders , 1978 .

[7]  U. J. Boughton,et al.  Platelet and Plasma β Thromboglobulin in Mycloproliferative Syndromes and Secondary Thrombocytosis , 1978, British journal of haematology.

[8]  T. Pearson,et al.  Vascular occlusive episodes and venous haematocrit in primary proliferative polycythaemia. , 1978, Lancet.

[9]  H. Hoagland,et al.  Primary thrombocythemia in the young patient. , 1978, Mayo Clinic proceedings.

[10]  K. Wu.  Platelet hyperaggregability and thrombosis in patients with thrombocythemia. , 1978, Annals of internal medicine.

[11]  P. Walsh,et al.  The Role of Platelets in the Pathogenesis of Thrombosis and Hemorrhage in Patients with Thrombocytosis , 1977, Thrombosis and Haemostasis.

[12]  P. Walsh.  Publication of Symposia in Thrombosis and Haemostasis , 1977, Thrombosis and Haemostasis.

[13]  Wasserman Lr.  The treatment of polycythemia vera. , 1976 .

[14]  N. Berlin.  Diagnosis and classification of the polycythemias. , 1975, Seminars in hematology.

[15]  A. D. Ginsburg.  Platelet function in patients with high platelet counts. , 1975, Annals of internal medicine.

[16]  V. Devita,et al.  Thrombocytosis in chronic granulocytic leukemia: incidence and clinical significance. , 1974, Blood.

[17]  D. Winfield,et al.  Essential Thrombocythaemia and Peripheral Gangrene , 1974, British medical journal.

[18]  L. Wasserman,et al.  Abnormalities of platelet function in patients with polycythemia vera. , 1973, Cancer research.

[19]  T. Barbui,et al.  Spontaneous Platelet Aggregation in Myeloproliferative Disorders , 1973 .

[20]  S. Zucker,et al.  Classification of thrombocytosis based on platelet function tests: correlation with hemorrhagic and thrombotic complications. , 1972, The Journal of laboratory and clinical medicine.

[21]  J. Neemeh,et al.  Quantitation of platelet aggregation in myeloproliferative disorders. , 1972, American journal of clinical pathology.

[22]  W. van Aken,et al.  Spontaneous aggregation of blood platelets as a cause of idiopothic thrombosis and recurrent painful toes and fingers. , 1971, Lancet.

[23]  J. Peterson,et al.  Effect of acetylsalicylic acid, other nonsteroidal anti-inflammatory agents, and dipyridamole on human blood platelets. , 1970, The Journal of laboratory and clinical medicine.

[24]  A. Dawson,et al.  The influence of the platelet count on the incidence of thrombotic and haemorrhagic complications in polycythaemia vera , 1970, Postgraduate medical journal.

[25]  F. Davey,et al.  Treatment of symptomatic thrombocythemia. , 1969, The New England journal of medicine.

[26]  T. Spaet,et al.  Defective platelets in essential thrombocythemia. , 1969, Archives of internal medicine.

[27]  L. Wasserman,et al.  SURGERY IN POLYCYTHEMIA VERA. , 1963, The New England journal of medicine.

[28]  T. Thiede,et al.  Complications and causes of death in polycythaemia vera. , 2009, Acta medica Scandinavica.

[29]  J. Pitcock,et al.  A clinical and pathological study of seventy cases of myelofibrosis. , 1962, Annals of internal medicine.

[30]  W. C. Levin,et al.  Primary hemorrhagic thrombocythemia. , 1960, The American journal of medicine.

[31]  F. Gunz,et al.  Hemorrhagic thrombocythemia: a critical review. , 1960, Blood.

[32]  H. Wolff,et al.  Haemorrhagic Thrombocythaemia: a Clinical and Laboratory Study , 1955, British journal of haematology.

[33]  L. Wasserman.  Polycythemia vera: its course and treatment; relation to myeloid metaplasia and leukemia. , 1954, Bulletin of the New York Academy of Medicine.