Forty-eight patients with myelodysplastic syndromes and a platelet count greater than 80 x 109/L were the subjects of a study of platelet function. A whole-blood platelet lumi-aggregometer was used for simultaneous measurement of platelet aggregation by the impedance method and of adenosine triphosphate-dense granule release. The results were correlated with skin bleeding time and episodes of clinical bleeding or thrombosis. Thirty-five patients had at least 1 abnormal result indicating platelet hypoactivity; 7 patients had mixed platelet hypoactivity and hyperactivity; and 4 patients had platelet hyperactivity. Only 2 patients had normal results. There was good correlation between platelet hypoactivity and prolonged skin bleeding time (P = .005); however, several patients with platelet hypoactivity had normal skin bleeding times. This finding suggested that whole-blood platelet aggregation studies may be more sensitive than bleeding time in identification of patients at risk of bleeding. Clinical hemorrhage was frequent (32 patients) in this cohort despite platelet counts greater than 100 x 109/L. This finding indicated platelet hypofunction was clinically important. In contrast, only 2 of the 13 patients with thrombotic events had evidence of platelet hyperactivity, suggesting that other clinical factors are probably more important determinants of thrombosis. These observations confirm that platelet dysfunction is common in patients with myelodysplastic syndromes and suggest a useful role for routine whole-blood platelet aggregation studies to identify patients at risk of bleeding.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Ganser A, Hoelzer D. Clinical course of myelodysplastic syndromes.Hematol Oncol Clin North Am. 1992;6:607–618.
Maldonado JE, Pierre RV. The platelets in preleukemia and myelomonocytic leukemia: ultrastructural cytochemistry and cytogenetics.Mayo Clin Proc. 1975;50:573–587.
Cowan DH, Graham RCJ, Baunach D. The platelet defect in leukemia. platelet ultrastructure, adenine nucleotide metabolism, and the release reaction.J Clin Invest. 1975;56:188–200.
Stuart JJ, Lewis JC. Platelet aggregation and electron microscopic studies of platelets in preleukemia.Arch Pathol Lab Med. 1982;106:458–461.
Pamphilon DH, Aparicio SR, Roberts BE, Menys VC, Tate G, Davies JA. The myelodysplastic syndromes: a study of haemostatic function and platelet ultrastructure.Scand J Haematol. 1984;33:486–491.
Berndt MC, Kabral A, Grimsley P, Watson N, Robertson TI, Brad-stock KF. An acquired Bernard-Soulier-like platelet defect associated with juvenile myelodysplastic syndrome.Br J Haematol. 1988;68:97–101.
Rasi V, Lintula R. Platelet function in the myelodysplastic syndromes.Scand J Haematol. 1986;45:71–73.
Meschengieser S, Blanco A, Maugeri N, et al. Platelet function and intraplatelet von Willebrand factor antigen and fibrinogen in myelodysplastic syndromes.Thromb Res Suppl. 1987;46:601–606.
De Cataldo F, Baudo F, Redaelli R, Corno AR. Abnormal platelet von Willebrand factor (vWF) as a marker of abnormal function in megakaryocytic dysplasia.Am J Hematol. 1995;48:155–157.
Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the myelodysplastic syndromes.Br J Haematol. 1982;51:189–199.
Bertolino G, Noris P, Balduini CL. Effect of different sample preparation methods on the results of the impedence technique in the study of platelet hyper- and hypo-function in whole blood.Thromb Res. 1993;71:89–94.
Boyd DG, Davis RB. Observations on human platelet aggregation in native whole blood: synergism and sensitivity to aggregating agents in vitro.Thromb Res. 1998;50:429–436.
Riess H, Braun G, Brehm G, Hiller E. Critical evaluation of platelet aggregation in whole human blood.Am J Clin Pathol. 1986;85:50–56.
Balduini CL, Bertolino G, Gamba G, et al. Platelet aggregation in platelet rich plasma and whole blood in 18 patients affected by idiopathic myelofibrosis.Eur J Haematol. 1988;41:267–272.
Born GV, Hume M. Effects of the numbers and sizes of platelet aggregates on the optical density of plasma.Nature. 1967;215:1027–1029.
Raman BK, Van Slyck EJ, Riddle J, Sawdyk MA, Abraham JP, Saeed SM. Platelet function and structure in myeloproliferative disease, myelodysplastic syndrome, and secondary thrombocytosis.Am J Clin Pathol. 1989;91:647–655.
Mittleman M, Zeidman A. Platelet function in the myelodysplastic syndromes.Int J Hematol. 2000;71:95–98.
Knottenbelt E, Jacobs P, Wilson EL. A prospective analysis of prognostic factors in the myelodysplastic syndromes.S Afr Med J. 1990;77:69–74.
Barbui T, Cortelazzo S, Viero P, Buelli M, Bassan R. Infection and hemorrhage in elderly acute myeloblastic leukemia and primary myelodysplasia.Hematol Oncol. 1993;11:15–18.
Manoharan A, Gemmell R, Brighton T, Dunkley S, Lopez K, Kyle P. Thrombosis and bleeding in myeloproliferative disorders: identification of at-risk patients with whole blood platelet aggregation studies.Br J Haematol. 1999;105:618–625.
About this article
Cite this article
Manoharan, A., Brighton, T., Gemmell, R. et al. Platelet Dysfunction in Myelodysplastic Syndromes: A Clinicopathological Study. Int J Hematol 76, 272–278 (2002). https://doi.org/10.1007/BF02982798
- Myelodysplastic syndrome
- Platelet function