Can Histochemical c-mpl Positivity in Bone Marrow be a Predictor for Splenectomy in Immune Thrombocytopenia?

Main Article Content

Irfan Yavasoglu
Nadide Gencer
Fulden Cantas
Firuzan Doger
Zahit Bolaman

Abstract

Purpose: Splenectomy is used as the second line therapy in patients with immune thrombocytopenia (ITP). However, there is no parameter predicting splenectomy decision. Thrombopoietin is the main regulator of platelet count through its receptor c-mpl. The aim of the present study was to evaluate immune histochemical Cloned Myeloid Leukemia Virus (c-mpl) positivity in bone marrow specimens of ITP patients with or without splenectomy indications.

Methods: Pre-splenectomy bone marrow was stained for c-mpl, that was taken from 24 patients with ITP and who had splenectomy as well as bone marrow samples from 30 patients with ITP who did not have splenectomy.

Results: c-mpl negativity was higher in splenectomized patients (n: 23) compared to patients without splenectomy (n:18). A significant difference was found for platelet counts before and after splenectomy. Our study show that, c-mpl positivity was statistically significant in patient group who did not have splenectomy. In the patient group who had the splenectomy, c-mpl was not associated with refractory status. 

Conclusion: The significant level of c-mpl negativity might be the useful parameter for splenectomy indication in patients with immune thrombocytopenia.

Keywords:
Immune, thrombocytopenia, splenectomy, c-mpl positivity.

Article Details

How to Cite
Yavasoglu, I., Gencer, N., Cantas, F., Doger, F., & Bolaman, Z. (2019). Can Histochemical c-mpl Positivity in Bone Marrow be a Predictor for Splenectomy in Immune Thrombocytopenia?. International Blood Research & Reviews, 9(4), 1-4. https://doi.org/10.9734/ibrr/2019/v9i430107
Section
Short Research Article

References

Ghanima W, Godeau B, Cines DB, Bussel J. How I treat immune thrombocytopenia: The choice between splenectomy or a medical therapy as a second-line treatment. Blood. 2012;120:960–969.

Navez J, Hubert C, Gigot JF, Navez B, Lambert C, Jamar F, Danse E, Lannoy V, Jabbour N. Does the site of platelet sequestration predict the response to splenectomy in adult patients with immune thrombocytopenic purpura? Platelets. 2015;26(6):573-6.

Vianello F, Vettora S, Tezza F. Serum thrombopoetin and C-mpl expression in thrombocytopenia of different etiologies. Hemotology Reports. 2014;6: 4996.

Ng AP, Kauppi M, Metcalf D, Hyland CD, Josefsson EC, Lebois M, Zhang JG, Baldwin TM, Di Rago L, Hilton DJ, Alexander WS. Mpl expression on megakaryocytes and platelets is dispensable for thrombopoiesis butessential to prevent myeloproliferation. Proc Natl Acad Sci USA. 2014;111: 5884-9.

Drachman J, Griffin JD, Kaushansky K. Stimulation of tyrosine kinase activity by MPL-ligand (thrombopoietin). J Biol Chem. 1995;270:4979–82.

Gurney AL, Carver-Moore K, de Sauvage FJ, Moore MW. Thrombocytopenia in c-mpl-deficient mice. Science. 1994;265: 1445-7.

Passos-Coelho JL, Sebastião M, Gameiro P. Congenital Amegakaryocytic Thrombocytopenia — Report of a New c-mpl Gene Missense Mutation J. Am J Hematol. 2007;82: 240-1.

Ichikawa N, Kitano K, Shimodaira S. Changes in serum thrombopoietin levels after splenectomy. Acta Haematol. 1998; 100:137-41.