ORIGINAL RESEARCH ARTICLE

Mean platelet volume as a predictive marker for venous thromboembolism and mortality in patients treated for diffuse large B-cell lymphoma

Corresponding Author

Joanna Rupa-Matysek

[email protected]

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

Correspondence

Joanna Rupa-Matysek, Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Szamarzewskiego 84, 60-569 Poznań, Poland.

Email: [email protected]

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Lidia Gil,

Lidia Gil

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Renata Kroll-Balcerzak,

Renata Kroll-Balcerzak

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Marta Barańska,

Marta Barańska

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Mieczysław Komarnicki,

Mieczysław Komarnicki

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Joanna Rupa-Matysek,

Corresponding Author

Joanna Rupa-Matysek

[email protected]

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

Correspondence

Joanna Rupa-Matysek, Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Szamarzewskiego 84, 60-569 Poznań, Poland.

Email: [email protected]

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Lidia Gil,

Lidia Gil

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Renata Kroll-Balcerzak,

Renata Kroll-Balcerzak

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Marta Barańska,

Marta Barańska

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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Mieczysław Komarnicki,

Mieczysław Komarnicki

Department of Haematology, Poznan University of Medical Sciences, Poznań, Poland

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First published: 05 July 2016

https://doi.org/10.1002/hon.2321

Citations: 19

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Abstract

It has been suggested that mean platelet volume (MPV) is associated with the risk of venous thromboembolism (VTE) and increased mortality in patients with cancer.

We evaluated the association of MPV with VTE and mortality in patients treated for diffuse large B-cell lymphoma (DLBCL). Retrospective analyses were performed on 184 adult patients (median age 59, 55% men), of whom 141 were newly diagnosed, and 43 had relapse/refractory DLBCL.

During the observation period (median 499 days), 39 (21.2%) patients developed VTE. Thirty-nine patients died of various causes. In univariate analysis, only the MPV and the treatment line were associated with the occurrence of VTE. In multivariate analysis, MPV ≤10th percentile (odd ratio 1.81; 95% confidence interval 1.06–3.11, p = 0.03) and salvage therapy (odd ratio 2.46; 95% confidence interval 1.66–3.65, p < 0.001) remained significant factors for developing VTE. Other patient-related factors—age, gender, disease-related factors—stage, the International Prognostic Index score, DLBCL subclassification (the germinal centre type and the activated B-cell type), Ki-67 index and VTE risk assessment model failed to be prognostic for VTE.

In a Kaplan–Meier analysis, patients with MPV >10th percentile had statistically significantly longer VTE-free survival than patients with lower MPV. In multivariable Cox regression analysis, MPV ≤10th percentile (hazard ratio 5.56, p < 0.001), male gender, age, Ki-67 index, high or high-intermediate International Prognostic Index and VTE development (hazard ratio 7.81, p = 0.029) all significantly correlated with the risk of mortality. The probability of survival was higher in patients with MPV >10th percentile.

In conclusion, our results suggest that the pre-chemotherapy MPV value is a cheap and available parameter that may be a useful prognostic marker for a significant risk of VTE and inferior survival rates in patients with DLBCL.

REFERENCES

1Pabinger I, Thaler J, Ay C. Biomarkers for prediction of venous thromboembolism in cancer. Blood 2013; 122: 2011–2018.
10.1182/blood-2013-04-460147
CAS PubMed Web of Science® Google Scholar
2Khorana AA, Kuderer NM, Culakova E, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 2008; 111: 4902–4907.
10.1182/blood-2007-10-116327
CAS PubMed Web of Science® Google Scholar
3Riedl J, Pabinger I, Ay C. Platelets in cancer and thrombosis. Hamostaseologie 2014; 34: 54–62.
10.5482/HAMO-13-10-0054
CAS PubMed Web of Science® Google Scholar
4Riedl J, Kaider A, Reitter EM, et al. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS). Thromb Haemost 2014; 111: 670–678.
10.1160/TH13-07-0603
CAS PubMed Web of Science® Google Scholar
5Ferroni P, Guadagni F, Riondino S, et al. Evaluation of mean platelet volume as a predictive marker for cancer-associated venous thromboembolism during chemotherapy. Haematologica 2014; 99: 1638–1644.
10.3324/haematol.2014.109470
CAS PubMed Web of Science® Google Scholar
6Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW. WHO classification of tumours of haematopoietic and lymphoid tissues, fourth edition. IARC 2008; 2: 233.
Google Scholar
7A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 1993; 329: 987–994.
10.1056/NEJM199309303291402
CAS PubMed Web of Science® Google Scholar
8Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014; 32: 3059–3068.
10.1200/JCO.2013.54.8800
PubMed Web of Science® Google Scholar
9Hans CP, Weisenburger DD, Greiner TC, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood 2004; 103: 275–282.
10.1182/blood-2003-05-1545
CAS PubMed Web of Science® Google Scholar
10Caruso V, Di Castelnuovo A, Meschengieser S, et al. Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events. Blood 2010; 115: 5322–5328.
10.1182/blood-2010-01-258624
CAS PubMed Web of Science® Google Scholar
11Komrokji RS, Uppal NP, Khorana AA, et al. Venous thromboembolism in patients with diffuse large B-cell lymphoma. Leuk Lymphoma 2006; 47: 1029–1033.
10.1080/10428190600560991
PubMed Web of Science® Google Scholar
12Ottinger H, Belka C, Kozole G, et al. Deep venous thrombosis and pulmonary artery embolism in high-grade non Hodgkin's lymphoma: incidence, causes and prognostic relevance. Eur J Haematol 1995; 54: 186–194.
10.1111/j.1600-0609.1995.tb00214.x
CAS PubMed Web of Science® Google Scholar
13Mohren M, Markmann I, Jentsch-Ullrich K, et al. Increased risk of thromboembolism in patients with malignant lymphoma: a single-centre analysis. Br J Cancer 2005; 92: 1349–1351.
10.1038/sj.bjc.6602504
CAS PubMed Web of Science® Google Scholar
14Blom JW, Doggen CJ, Osanto S, Rosendaal FR. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 2005; 293: 715–722.
10.1001/jama.293.6.715
CAS PubMed Web of Science® Google Scholar
15Amer MH. Cancer-associated thrombosis: clinical presentation and survival. Cancer Manag Res 2013; 5: 165–178.
10.2147/CMAR.S47094
PubMed Google Scholar
16Buergy D, Wenz F, Groden C, Brockmann MA. Tumor-platelet interaction in solid tumors. Int J Cancer 2012; 130: 2747–2760.
10.1002/ijc.27441
CAS PubMed Web of Science® Google Scholar
17Yokoyama K, Murata M, Ikeda Y, Okamoto S. Incidence and risk factors for developing venous thromboembolism in Japanese with diffuse large B-cell lymphoma. Thromb Res 2012; 130: 7–11.
10.1016/j.thromres.2011.09.022
CAS PubMed Web of Science® Google Scholar
18Lim SH, Woo SY, Kim S, et al. Cross-sectional study of patients with diffuse large B-cell lymphoma: assessing the effect of host status, tumor burden and inflammatory activity on venous thromboembolism. Cancer Res Treat 2016; 48: 312–321.
10.4143/crt.2014.266
CAS PubMed Web of Science® Google Scholar
19Ziepert M, Hasenclever D, Kuhnt E, et al. Standard International Prognostic Index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era. J Clin Oncol 2010; 28: 2373–2380.
10.1200/JCO.2009.26.2493
CAS PubMed Web of Science® Google Scholar
20Sehn LH, Berry B, Chhanabhai M, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 2007; 109: 1857–1861.
10.1182/blood-2006-08-038257
CAS PubMed Web of Science® Google Scholar
21Sehn LH. Paramount prognostic factors that guide therapeutic strategies in diffuse large B-cell lymphoma. Hematology Am Soc Hematol Educ Program 2012; 2012: 402–409.
10.1182/asheducation.V2012.1.402.3798516
PubMed Web of Science® Google Scholar
22Agarwal R, Lade S, Liew D, et al. Role of immunohistochemistry in the era of genetic testing in MYC-positive aggressive B-cell lymphomas: a study of 209 cases. J Clin Pathol 2016; 69: 266–270.
10.1136/jclinpath-2015-203002
CAS PubMed Web of Science® Google Scholar
23Scott DW, Wright GW, Williams PM, et al. Determining cell-of-origin subtypes of diffuse large B-cell lymphoma using gene expression in formalin-fixed paraffin-embedded tissue. Blood 2014; 123: 1214–1217.
10.1182/blood-2013-11-536433
CAS PubMed Web of Science® Google Scholar
24Sehn LH, Gascoyne RD. Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity. Blood 2015; 125: 22–32.
10.1182/blood-2014-05-577189
CAS PubMed Web of Science® Google Scholar
25Sorensen HT, Mellemkjaer L, Olsen JH, Baron JA. Prognosis of cancers associated with venous thromboembolism. N Engl J Med 2000; 343: 1846–1850.
10.1056/NEJM200012213432504
CAS PubMed Web of Science® Google Scholar
26Stein PD, Beemath A, Meyers FA, et al. Incidence of venous thromboembolism in patients hospitalized with cancer. Am J Med 2006; 119: 60–68.
10.1016/j.amjmed.2005.06.058
PubMed Web of Science® Google Scholar
27Muller C, Murawski N, Wiesen MH, et al. The role of sex and weight on rituximab clearance and serum elimination half-life in elderly patients with DLBCL. Blood 2012; 119: 3276–3284.
10.1182/blood-2011-09-380949
CAS PubMed Web of Science® Google Scholar
28Park LC, Woo SY, Kim S, et al. Incidence, risk factors and clinical features of venous thromboembolism in newly diagnosed lymphoma patients: results from a prospective cohort study with Asian population. Thromb Res 2012; 130: e6–e12.
10.1016/j.thromres.2012.03.019
CAS PubMed Web of Science® Google Scholar

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Volume35, Issue4

December 2017

Pages 456-464

Mean platelet volume as a predictive marker for venous thromboembolism and mortality in patients treated for diffuse large B-cell lymphoma

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Mean platelet volume as a predictive marker for venous thromboembolism and mortality in patients treated for diffuse large B-cell lymphoma

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