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Vol. 24, Art. 2 (pp. 17-27)    |    2023       

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Fibrinolysis in patients with ph-negative myeloproliferative neoplasms

Silina N.N, Korsakova N.E., Golovina O.G., Tarkovskaya L.R., Smirnova O.A.,
Karpich S.A., Bessmeltsev S.S., Sidorkevich S.V., Papayan L.P.

Russian Research Institute of hematology and Transfusiology, Russia

Brief summary

Ph-negative myeloproliferative neoplasms (MPN) such as polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) are characterized by thrombotic complications. Currently there is not general diagnostic laboratory method for the development of thrombosis. Disorders in the system of fibrinolysis are one of the factors that contribute to the progress of thrombosis. The time of XIIa-dependent fibrinolysis, D-dimer level and fibrinolytic parameters of thromboelastography can extend with these patients and represent a change of the balance between blood coagulation and fibrinolysis. Aim of this study to estimate parameters of fibrinolysis in patients with Ph-negative myeloproliferative neoplasms. Materials and methods. The study involved 80 patients with MPN (29 with PV, 21 with ET and 30 with PMF) and 19 healthy controls. XIIa-dependent fibrinolysis (seconds), D-dimer level (ng/ml) and parameters of thromboelastography characterizing the results of the fibrinolysis process 30 and 60 minutes after reaching the maximum amplitude of clot formation (Ly30 and Ly60) were tested by instructions. Microsoft office Excel and STATISTICA 12.0 were used. Results: Ly30 and Ly60 (TEG) in patients with ET, PV and PMF were significantly lower than in the control group. The most expressed changes in fibrinolysis (prolongation of time XIIa-dependent fibrinolysis) are identified in patients with PMF, while this parameter in patients with PV and ET is not differ from the control but it has a tendency to both decrease and increase. Increase of the D-dimer level was found in all patients with MPN. Conclusion. Investigation of patients with MPN identified inhibition of fibrinolysis according to thromboelastography as well as an increase in the level of D-dimer. In patients with PV and PMF were detected significant changing of parameters. These changes indicated inhibition of fibrinolysis. Fibrinolytic system disfunction could lead to imbalance in hemostatic system with prothrombotic states development in MPN.


Key words

polycythemia vera, essential thrombocythemia, primary myelofibrosis, the time of XIIa-dependent fibrinolysis, D-dimer level, thromboelastography

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