平均血小板体积在慢性淋巴细胞白血病中具有预后价值。
Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia.
作者信息
Masternak Marta, Puła Bartosz, Knap Joanna, Waszczuk-Gajda Anna, Drozd-Sokołowska Joanna, Wdowiak Kamil, Grosicki Sebastian, Kozłowska Izabela, Kaźmierczak Marta, Łabędź Anna, Szukalski Łukasz, Wiśniewski Kamil, Subocz Edyta, Hałka Janusz, Szymczyk Agnieszka, Hus Marek, Jamroziak Krzysztof, Giannopoulos Krzysztof
机构信息
Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland.
Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
出版信息
Cancer Manag Res. 2020 Oct 12;12:9977-9985. doi: 10.2147/CMAR.S246385. eCollection 2020.
PURPOSE
Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation.
PATIENTS AND METHODS
The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann-Whitney, Kruskal-Wallis, Kaplan-Meier, chi-squared, log‑rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data.
RESULTS
The receiver operating characteristic curve analysis was performed to identify optimal cut-off value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cut-off value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259).
CONCLUSION
Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.
目的
平均血小板体积（MPV）是一种易于获取且常用的血液学指标。近期研究表明，MPV对包括某些类型癌症在内的多种疾病的病程和预后以及心房颤动和出血的发生率有显著影响。本研究旨在对首次治疗时间（TTFT）方面的MPV进行回顾性分析，并确定其在慢性淋巴细胞白血病（CLL）患者组中的预后价值。此外，该研究还包括对接受依鲁替尼治疗的患者的血小板参数与出血和心房颤动情况的回顾性分析。
患者与方法
该研究纳入了523例CLL患者，其中344例报告了最重要的细胞遗传学异常。采用曼-惠特尼检验、克鲁斯卡尔-沃利斯检验、卡普兰-迈耶检验、卡方检验、对数秩检验以及多变量Cox比例风险回归模型对收集的数据进行分析。
结果
进行了受试者工作特征曲线分析以确定MPV的最佳临界值。生存曲线分析表明，MPV值较高的患者组的TTFT明显长于MPV值较低的患者组（17.9个月对36个月，p = 0.0015，MPV的临界值 = 10.4 fl）。在多变量Cox比例风险回归模型中，低MPV、存在del11q和del13q为TTFT提供了独立的预后价值（HR = 0.69，95%置信区间，0.5293至0.9081；p = 0.0078；HR = 1.76，95%置信区间，1.3000至2.3882，p = 0.0003，HR = 0.74，95%置信区间，0.5674至0.9588，p = 0.0229，分别）。在接受依鲁替尼治疗的患者组中，59例患者的MPV水平与治疗并发症发生率之间无显著相关性，尽管在低MPV患者组中，心房颤动的发生倾向更频繁（p = 0.259）。
结论
低MPV值与不良预后相关，可能是CLL中一种新的独立预后因素。
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