Abstract
Background. PV and ET have high predisposition to thrombosis and recurrence of thrombosis. We determined VEGF, D-dimer and coagulation activation markers in clinically stable patients and recurrence of thrombosis. Methods. Thirty-five Indonesian patients diagnosed with PV and ET and under treatment for the disease were recruited. The following assays were performed: VEGF, D-dimer, fibrinogen, TAT-complex, vWF, β-TG and JAK2 V617F mutation. Data between patients who were clinically stable(n=20) and those with recurrent thrombosis (n=15) at the time of study was analysed. Results. The mean age for PV/ET was 51.7 ± 14.9 years. Thrombosis episode was recorded for 94.3% (33/35) patients. Twenty (57.1%) clinically stable and 15 (42.9%) patients had recurrence of thrombosis. D-dimer (P=<0.001), fibrinogen (P=0.005) were statistically significant and VEGF (P=0.06) were seen in recurrence of thrombosis compared to clinically stable patients who had normal D-dimer. Elevated D-dimer seen in recurrence thrombosis was significantly correlated with VEGF (P=0.002) levels. Elevated VEGF were seen in 45% of clinically stable patients and 73.3% in recurrence of thrombosis. Conclusions. Elevated D-dimer and fibrinogen with higher mean VEGF levels were seen in recurrence of thrombosis. VEGF and D-dimer measurements have clinical use in determining the risk of patients with vascular complications.
Highlights
Polycythemia vera (PV) and essential thrombocythemia (ET) are Philadelphia negative myeloproliferative neoplasms (MPNs) with cardinal features of an increased red cell mass in PV and high platelet count in except for patients (ET) [1, 2]
Elevated D-dimer and fibrinogen with higher mean VEGF levels were seen in recurrence of thrombosis
Polycythemia vera (PV) and essential thrombocythemia (ET) are Philadelphia negative myeloproliferative neoplasms (MPNs) with cardinal features of an increased red cell mass in PV and high platelet count in ET [1, 2]. They have high predisposition to thrombosis with a rate of major thrombosis as high as about 50% [3, 4]. It is associated with JAK2V617F somatic mutation which carries an enhanced risk of thrombosis [5] but their role in thrombotic complications is not entirely clear
Summary
Polycythemia vera (PV) and essential thrombocythemia (ET) are Philadelphia negative myeloproliferative neoplasms (MPNs) with cardinal features of an increased red cell mass in PV and high platelet count in ET [1, 2] They have high predisposition to thrombosis with a rate of major thrombosis as high as about 50% [3, 4]. It is a very useful diagnostic tool in the management of patients with suspected DVT and pulmonary embolism (PE) [20] and has been shown to have a high sensitivity and a high negative predictive value for DVT exclusion [21] It is a marker for hypercoagulability and links with venous as well as arterial thrombotic events and has been used to determine the hypercoagulable state leading to thrombosis in PV and ET [22, 23]. We determined VEGF, D-dimer and coagulation activation markers in clinically stable patients and recurrence of thrombosis
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