PB1461 - Effect of therapy on thrombin generation in patients with polycythemia vera

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Natalia Silina, PhD

Head
Russian Research Institute of Hematology and Transfusiology
Saint-Petersburg, Saint Petersburg City, Russia

Co-Author(s)

Natalia Korsakova, PhD

senior researcher
Russian Research Institute of Hematology and Transfusiology
Saint-Petersburg, Saint Petersburg City, Russia
OG

Olga Golovina

leader researcher
Russian Research Institute of Hematology and Transfusiology
Saint-Petersburg, Saint Petersburg City, Russia
Olesia Matvienko, PhD

lead researcher
Russian Research Institute of Hematology and Transfusiology
Saint-Petersburg, Saint Petersburg City, Russia
Olga Smirnova, PhD

senior researcher
Russian Research Institute of Hematology and Transfusiology
Saint-Petersburg, Saint Petersburg City, Russia
EE

Elizaveta Efremova

haematologist
Russian Research Institute of Haematology and Transfusiology
Saint Petersburg, Saint Petersburg City, Russia
SV

Sergey Voloshin

haematologist
Russian Research Institute of Haematology and Transfusiology
Saint Petersburg, Saint Petersburg City, Russia

Background: Polycythemia vera (PV) is a clonal disease that belongs to the group of myeloproliferative neoplasms. The most patients have a JAK2V617F mutation that plays a common role in the etiology and pathogenesis of disease and it is a risk factor of thrombosis. Prevention of thrombotic complications is a major issue in the management of these patients.

Aims: to compare the effect of cytoreductive and / or antiplatelet therapy on thrombin generation in patients with PV.

Methods: 38 patients were examined. 18 people were treated with acetylsalicylic acid in prophylactic doses (Group 1) and 20 patients were on cytoreductive therapy in combination with antiplatelet agents (Group 2). The control group consisted of 43 healthy individuals. Thrombin generation was assessed by calibrated automated thrombinography (CAT) according to Hemker et al. with or without thrombomodulin (TM). The following parameters were evaluated: endogenous thrombin potential (ETP, nM*min) and peak thrombin (Peak thrombin, nM). Sensitivity ETP and Peak thrombin for TM were calculated as percent of decreasing of these parameters after adding to assay of TM (Sensitivity ETP, % and Sensitivity Peak thrombin, % respectively). Decreasing of these parameters indicates disability of anticoagulant protein C system and it is a potential risk factor of thrombotic complications. Microsoft office Excel and STATISTICA 12.0 was used. The results are given as median (Me) with 50% confidence intervals (CI). Mann-Whitney test was used to compare the studied groups. P< 0.05 was considered statistically significant.

Results: The data are shown in the table. Sensitivity to TM was significantly reduced in patients of both groups. The parameters of sensitivity to TM in patients of the second group were significantly lower than those in the first group.

Conclusion(s): The treating with the combination therapy has a more pronounced risk of thrombotic complications than that in patients on the antiplatelet therapy.