International Journal of Hematology

, Volume 107, Issue 2, pp 166–172 | Cite as

Increased mean platelet volume (MPV) is an independent predictor of inferior survival in patients with primary and secondary myelofibrosis

  • Marko Lucijanic
  • Zdravko Mitrovic
  • David Cicic
  • Zeljko Prka
  • Vlatko Pejsa
  • Ana Livun
  • Tajana Stoos-Veic
  • Zeljko Romic
  • Marcela Zivkovic
  • Iva Lucijanic
  • Zrinka Fabris
  • Rajko Kusec
Original Article

Abstract

Neoplastic megakaryopoiesis is a dominant feature of Philadelphia-chromosome-negative myeloproliferative neoplasms (Ph− MPNs), and elevated mean-platelet-volume (MPV) is a common finding in these diseases. The clinical and prognostic significances of MPV in patients with primary (PMF) and secondary myelofibrosis (SMF) have not been reported. We retrospectively analyzed 87 patients with myelofibrosis (66 with PMF, 21 with SMF) treated at our institution. MPV was recorded in addition to other hematological and clinical parameters. MPV was elevated in both PMF and SMF patients in comparison to controls, whereas there was no statistically significant difference between PMF and SMF. Elevated MPV was associated with lower platelets (P = 0.016), higher white blood cells (P = 0.015), higher percentage of circulatory blasts (P = 0.009), higher lactate dehydrogenase (P = 0.011), larger spleen size (P = 0.014) and higher Dynamic International Prognostic score category (P = 0.027), while there was no statistically significant association with driver mutations or degree of bone marrow fibrosis. Higher MPV was univariately associated with inferior overall survival in the whole cohort (HR = 3.82, P = 0.006), PMF (HR = 4.35, P = 0.007) and SMF patients (HR = 7.22, P = 0.034). These associations remained significant in multivariate analyses adjusted for DIPSS. Higher MPV is associated with more aggressive disease features and exhibits powerful independent prognostic properties in both PMF and SMF settings.

Keywords

Philadelphia chromosome negative myeloproliferative neoplasm Primary myelofibrosis Mean platelet volume Survival 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Ethical approval

The study was approved by the University Hospital Dubrava Review Board.

Informed consent

All subjects provided written informed consent for molecular studies.

Funding

None.

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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Marko Lucijanic
    • 1
  • Zdravko Mitrovic
    • 1
    • 5
  • David Cicic
    • 1
  • Zeljko Prka
    • 1
  • Vlatko Pejsa
    • 1
    • 5
  • Ana Livun
    • 2
  • Tajana Stoos-Veic
    • 3
    • 4
  • Zeljko Romic
    • 6
  • Marcela Zivkovic
    • 6
  • Iva Lucijanic
    • 5
  • Zrinka Fabris
    • 7
  • Rajko Kusec
    • 1
    • 2
    • 5
  1. 1.Hematology DepartmentUniversity Hospital DubravaZagrebCroatia
  2. 2.Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory DiagnosticsUniversity Hospital DubravaZagrebCroatia
  3. 3.Department of Clinical Cytology and CytometryUniversity Hospital DubravaZagrebCroatia
  4. 4.Faculty of MedicineUniversity of OsijekOsijekCroatia
  5. 5.School of MedicineUniversity of ZagrebZagrebCroatia
  6. 6.Clinical Department of Laboratory DiagnosticsUniversity Hospital DubravaZagrebCroatia
  7. 7.Radiology DepartmentGeneral Hospital DubrovnikDubrovnikCroatia

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