Abstract
Background: Although the distinction between clonal and reactive thrombocytosis is
clinically relevant because clonal thrombocytosis has more thrombohemorragic complications,
the differential diagnosis of these two entities can be difficult. Methods such as
the detection of unstimulated erythroid or megakaryocyte colony growth are not readily
available. Therefore, we measured blood thrombopoietin levels to determine whether
these levels can be used to distinguish the two conditions.
Patients and Methods: Thrombopoietin levels were measured in 73 patients with thrombocytosis
(platelet count >500,000/μL), including 39 patients with clonal thrombocytosis (20
patients with essential thrombocythemia, 15 with agnogenic myeloid metaplasia, 1 patient
with polycythemia vera, and 3 with undefined myeloproliferative disorders) and 34
patients with reactive thrombocytosis (17 with malignant tumors, 11 with inflammatory
diseases, 4 with sickle cell disease, and 2 with iron deficiency anemia). Seventeen
normal volunteers were used as controls.
Results: Thrombopoietin levels were significantly higher (P <0.05) in patients with clonal thrombocytosis (mean ± SD of 555 ± 585 pg/mL), including
the subgroup with essential thrombocythemia (505 ± 459 pg/mL), than in patients with
reactive thrombocytosis (290 ± 133 pg/mL) who had similar levels as controls (201
± 112 pg/mL). Thrombopoietin levels in patients with clonal thrombocytosis, including
essential thrombocythemia, were not correlated with platelet counts.
Conclusions: Thrombopoietin levels may be helpful in distinguishing between clonal
thrombocytosis and reactive thrombocytosis. Thrombopoietin is probably responsible
for the elevated platelet counts in clonal thrombocytosis including essential thrombocythemia,
but not in reactive thrombocytosis. High thrombopoietin levels in patients with clonal
thrombocytosis cannot be explained solely by platelet megakaryocyte mass.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
February 25,
1998
Received in revised form:
February 25,
1998
Received:
October 14,
1997
Footnotes
☆Supported in part by the Lee Streich Memorial Fund for Cancer Research and Dworetz-Wolf-Hoffman Foundation.
Identification
Copyright
© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
