1094 - Prevention of the thrombotic complications in patients with essential thrombocythemia

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Haematologic Malignancies
Presenter Oana Viola Badulescu
Authors O.V. Badulescu1, C. Badescu2, M. Ciocoiu3, M. Badescu3
  • 1Hematology, University of Medicine and Pharmacy "Gr.T.Popa", 700115 - Iasi/RO
  • 2Internal Medicine, University of Medicine and Pharmacy "Gr.T.Popa", 700115 - Iasi/RO
  • 3Pathophysiology, University of Medicine and Pharmacy "Gr.T.Popa", 700115 - Iasi/RO

Abstract

Essential thrombocythemia (ET) is a clonal myeloproliferative disorder characterized by an autonomous increase in platelet production. A typical characteristic of ET is a hemostatic imbalance resulting in increased risk for thrombotic events. Numerous factors are likely to contribute to the pathogenesis of thrombosis, including platelet number, activation of platelets and leukocytes and their interaction to form platelet leucocyte aggregates, in addition to prothrombotic circulating and endothelial factors. The objective of this study was to investigate the efficacy of anticoagulant treatment in the prevention of thrombotic events, in patients with ET with or without cardiovascular disease (CVD), by monitoring specific markers of the coagulation profile.

Material and methods

The study comprises 40 patients divided in 2 groups: 20 patients with ET (ET) and 20 patients with ET with CVD associated (ET + CVD). The patients were tested by determining three factors of coagulation profile: von Willebrand factor, Protein S and PAI-1, before and after administration of anticoagulant therapy. Warfarin® was administrated as anticoagulant treatment, in doses that were adjusted according to the INR (International Normalized Ratio) values.

Results

The level of the studied parameters were found significantly modified in both groups of patients (ET, ET + CVD) (p < 0,001). After the administration of anticoagulant treatment, in the first group (ET), it was observed a direct correlation between the treatment and the values of investigated parameters; in this group, the levels of studied parameters returned close to normal values. This correlation was less evident in the second group of patients (ET + CVD), as the monitored values, although lower than the levels at the begining of the treatement, remained within pathologic levels.

Conclusions

In ET the risk for thrombosis is due to endothelial dysfunction and changes in prothrombotic circulating factors. The anticoagulant treatment prevents only partially the occurrence of thrombotic events, but does not completely stop it. In spite of the anticoagulant therapy, the patients with ET present a high risk for developing thrombotic complications.

Disclosure

All authors have declared no conflicts of interest.