Platelet counts and haemorrhagic diathesis in patients with myelodysplastic syndromes.

Abstract

OBJECTIVES:

Most patients with myelodysplastic syndromes (MDS) present with single or multiple lineage cytopenias in peripheral blood despite a hypercellular bone marrow. Thrombocytopenia, attributable to ineffective platelet production by dysfunctional megakaryocytes, has been estimated to occur in 40-65% of patients. However, there are hardly any studies on the clinical relevance of low platelet counts in MDS.

METHODS:

We retrospectively analysed data from 2900 patients in the Duesseldorf MDS Registry who were diagnosed at our laboratory between 1982 and 2007.

RESULTS:

At the time of diagnosis, 43% of the patients had a platelet count lower than 100 000/microL. Platelets were lower than 20 000/microL in 7% of the patients, especially in those with advanced stages of MDS, who showed a higher frequency of thrombocytopenia and platelet transfusion dependency. On multivariate analysis, platelet anisometry, hypocellularity of megakaryopoiesis, maturational defects of megakaryocytes and platelets <20 000/microL were independent variables showing a statistically significant correlation (P < 0.05) with clinical signs of bleeding. Platelets lower than 100 000/microL were associated with significantly shortened survival (P < 0.00005), because of an increased risk of progression to acute myeloid leukaemia (AML) (30% vs. 21%) (P < 0.02) and bleeding (16% vs. 8%) (P = 0.0005).

CONCLUSIONS:

Thrombocytopenia is a strong predictor of short survival, with or without haemorrhagic complications.

• Authors: Judith Neukirchen, Sabine Blum, Andrea Kuendgen, Corinna Strupp, Manuel Aivado, Rainer Haas, Carlo Aul, Norbert Gattermann, Ulrich Germing
• Journal: European journal of haematology (Eur J Haematol) Vol. 83 Issue 5 Pg. 477-82 (Nov 2009) ISSN: 1600-0609 [Electronic] England
• PMID: 19548919 (Publication Type: Journal Article)

Topics

• Disease-Free Survival
• Female
• Hemorrhagic Disorders (blood, complications, mortality, therapy)
• Humans
• Leukemia, Myeloid, Acute (blood, etiology, mortality, therapy)
• Male
• Myelodysplastic Syndromes (blood, complications, mortality, therapy)
• Platelet Count
• Platelet Transfusion
• Predictive Value of Tests
• Registries
• Retrospective Studies
• Survival Rate
• Thrombocytopenia (blood, complications, mortality, therapy)