Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer

Julia Riedl; Alexandra Kaider; Eva-Maria Reitter; Christine Marosi; Ulrich Jäger; Ilse Schwarzinger; Christoph Zielinski; Ingrid Pabinger; Cihan Ay

doi:10.1160/TH13-07-0603

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2014; 111(04): 670-678
DOI: 10.1160/TH13-07-0603

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

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)

Julia Riedl

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Alexandra Kaider

²Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria

,

Eva-Maria Reitter

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Christine Marosi

³Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Ulrich Jäger

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Ilse Schwarzinger

⁴Department of Laboratory Medicine, Medical University of Vienna, Austria

,

Christoph Zielinski

³Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Ingrid Pabinger

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

,

Cihan Ay

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

^*Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria

› Author Affiliations

Abstract

Summary

Venous thromboembolism (VTE) is a frequent complication in cancer patients. Mean platelet volume (MPV) has been associated with arterial and venous thrombosis in patients without cancer. We analysed MPV in cancer patients and investigated the association of MPV with risk of VTE and mortality. MPV was routinely determined in the Vienna Cancer and Thrombosis Study, a prospective, observational cohort study of patients with newly diagnosed or progressive cancer after remission. Study endpoints were occurrence of symptomatic VTE or death during a maximum follow-up of two years. Out of 1,544 included patients, 114 (7.4%) developed VTE and 573 (37.1%) died during a median observation time of 576 days. High MPV ≥75^th percentile of the study population; ≥10.8 fL) was associated with decreased risk of VTE compared to MPV below the 75th percentile (HR [95% CI]: 0.59 [0.37–0.95], p=0.031). In multivariable analysis, including age, sex, cancer groups, newly diagnosed vs recurrent disease, platelet count and soluble P-selectin, this association remained statistically significant (0.65 [0.37–0.98], p=0.041). Mortality of patients with MPV (≥75th percentile was significantly decreased compared to those with lower MPV (0.72 [0.59–0.88], p=0.001). Two-year probability of VTE and overall survival was 5.5% and 64.7% in patients with high MPV compared to 9% and 55.7% in those with lower MPV. In conclusion, high MPV is associated with decreased VTE risk and improved survival in cancer patients. This finding is contrary to results observed in patients without cancer. Further studies are needed to confirm our results and elucidate underlying mechanisms.

Previous presentations of this manuscript: Data from this study were presented in part at the Annual Spring Meeting of the Austrian Society for Haematology and Oncology (OeGHO) in Linz, Austria, and as an oral presentation at the XXIV. Congress of the International Society on Thrombosis and Haemostasis (ISTH) 2013 in Amsterdam, the Netherlands.

Keywords

Mean platelet volume - cancer - venous thromboembolism - platelets - mortality

Full Text

References

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