PB2218 MONITORING OF BIOCHEMICAL PARAMETERS AND THROMBOEMBOLIC COMPLICATIONS IN PATIENTS WITH PHILADELPHIA NEGATIVE MYELOPROLIFERATIVE NEOPLASMS
Authors: Simonovic E. , Colic V. 
Published: June 2019

Background:

Myeloproliferative neoplasms (MPN) are the group of clonal, malignant hematopoietic stem cell disorders, characterized by the proliferation of one or more blood lines with normal or nearly normal maturing in the bone marrow and in extramedullar hematopoietic organs. MPNs are acquired prothrombogenic conditions. It is thought that the mechanisms that lead to thrombosis in MPN are the following: increased blood cell; abnormal platelet function and the phenomenon of spontaneous aggregation. In patients with MPN there is increased activity of the coagulation system due to the resistance to the anticoagulant function of thrombomodulin.

Aims:

The aim of this study is to monitor certain biochemical parameters and thromboembolic complications in patients with chronic Philadelphia negative myeloproliferative neoplasms. We have simultaneously monitored the presence of JAK2V617F mutation in those patients, as well as its correlation with biochemical parameters.

Methods:

Over a five‐year period, we monitored 129 patients of both sexes, aged between 30 and 82 years, being diagnosed with Ph‐negative myeloproliferative neoplasm. Patients were classified into the following groups: 1. Group with polycythemia vera (PV) (51); 2.Group with essential thrombocythemia (ET) (28); 3.Group with primary myelofibrosis (PMF) (21); 4. Group with myeloproliferative neoplasm unclassified (MPNs) (29). Among biochemical parameters, we monitored the levels of lactate dehydrogenase, urate, cholesterol, C‐reactive protein, total proteins and albumins. Each group of patients was divided into two subgroups: A) patients with JAK2V617F‐positive mutation; B) patients with JAK2V617F‐negative mutation. We used methods of clinical, laboratory, ultrasound and CT scans.

Results:

JAK2V617F mutation was statistically more significantly present in patients with PV (about 81%). In patients with ET it was noticed 58%, in patients with PMF about 38%, and in group of patients with MPNs about 48%. The highest percentage of thrombotic complications (arterial and venous) was found in the group of patients with ET, which was statistically more significant relative to PV. Thrombotic complications were in both groups more frequent in percentage with JAK2V617F positive patients, but without statistical significance. At the same time, LDH and cholesterol values statistically significantly higher in the PV and ET group of patients, who had some of the thromboembolic complications. The percentage of LDH and cholesterol values were higher in the group of patients who were JAK2V617F positive, but without statistical significance. CRP values were also higher in percentage in the group of patients with thrombotic complications who were JAK2V617F positive, but without statistical significance. Urate values were elevated in all patient groups but without statistical significance in relation to the occurrence of thromboembolic complications.

Summary/Conclusion:

The level of LDH, cholesterol, and CRP in patients with Philadelphia negative myeloproliferative neoplasms could be a significant indication of possible thromboembolic complications, particularly in correlation with the presence of JAK2V617F mutations. Those parameters could also have a significant role in defining the risk factors for the incidence of thromboembolic complications in those patients. Further monitoring is required and larger number of subjects.