Rashmi Kushwaha
King George’s Medical University, India
Title: Hemostatic profile in patients of Myeloproliferative Neoplasms- 5 year experience from a tertiary care centre in North India.
Biography
Biography: Rashmi Kushwaha
Abstract
Background: Patients of myeloproliferative neoplasm (MPN) commonly present with abnormalities in coagulation tests that are consistent with hypercoagulable state. Some individuals with MPN exhibit a pattern of exclusive bleeding or thrombotic events, many others have both bleeding and thrombosis.
Objectives: To assess the hemostatic defects and platelet functions in patients of MPN.
Methods: Five year prospective study done at a tertiary care centre in North India. All recently diagnosed cases of MPN along with 50 age and sex matched controls were included.
Patients on antiplatelet drugs, antimyeloproliferative treatment, vitamin K agonists or antagonists, OCP’s, Platelet count <1,00, 000/μl, high grade fever, liver disease, pregnancy were excluded.
All the patients underwent screening investigations like CBC, peripheral smear evaluation, Bleeding time , Prothrombin time , Activated Partial Thromboplastin Time , Protein C and S measurement, aggregation with ADP 5μM (CHRONOLOG 700).
Result: 50 cases were included. There was an occult prothrombotic state, suggested by significantly ( p<0.001) reduced levels of Protein C, Protein S. But no patient presented with frank thrombosis. 8 out of 50 patients had hemorrhagic manifestations ranging from subdural hematoma to pin point petechial hemorrhages. Patients of CML-CP, ET, PV, PMF, MPNNOS
showed significantly reduced maximal aggregation with 5μM ADP (p<0.001). MPV also showed a statistically significant increase in these patients.
Conclusion: Thrombohaemorrhagic complications significantly affect the morbidity and mortality of MPN patients. Timely diagnosis of hemostatic abnormalities can decrease the morbidity in these patients.