Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: ©Croatian Society of Medical Biochemistry and Laboratory Medicine.
Copyright: 2023, Croatian Society of Medical Biochemistry
License (open-access):
This is an Open Access article distributed under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 05 October 2022
Date accepted: 02 February 2023
Publication date (electronic): 15 April 2023
Publication date (print): 15 June 2023
Volume: 33
Issue: 2
Electronic Location Identifier: 020901
Publisher ID: bm-33-2-020901
DOI: 10.11613/BM.2023.020901
Higher estimated plasma volume status is associated with increased thrombotic risk and impaired survival in patients with primary myelofibrosis
Ena Soric[1]
Anica Sabljic[1]
Martina Moric Peric[10]
Ivan Zekanovic[10]
[1] Hematology Department, University Hospital Dubrava, Zagreb, Croatia
[2] University of Zagreb School of Medicine, Zagreb, Croatia
[3] Department of Internal Medicine, General Hospital Sibenik, Sibenik, Croatia
[4] University of Rijeka School of Medicine, Rijeka, Croatia
[5] Department of Hematology, University Hospital Center Split, Split, Croatia
[6] University of Split School of Medicine, Split, Croatia
[7] Department of Internal Medicine, “Dr. Josip Bencevic” General Hospital, Slavonski Brod, Croatia
[8] University of Osijek Faculty of Medicine, Osijek, Croatia
[9] Department of Hematology, Osijek University Hospital, Osijek, Croatia
[10] Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
Author notes:
[*] Corresponding author: markolucijanic@yahoo.com
Introduction
Blood plasma represents a large reservoir of cytokines and other mediators of inflammation. Higher estimated plasma volume status (ePVS) has been shown to correlate with increased thrombotic risk in polycythemia vera patients, but its clinical and prognostic associations in patients with myelofibrosis are unknown which we aim to evaluate in this study.
Materials and methods
We retrospectively analysed a multicentric cohort of 238 patients with primary (PMF) and secondary myelofibrosis (SMF). Estimated plasma volume status was calculated using the Strauss-derived Duarte formula. Overall survival (OS) and time to thrombosis (TTT) considering both arterial and venous thromboses were primary endpoints of interest.
Results
Median ePVS was 5.8 dL/g and it did not significantly differ between PMF and SMF patients. Patients with more advanced disease features, more pronounced inflammation and higher comorbidity burden had higher ePVS. Higher ePVS (> 5.6 dL/g) was associated with shorter OS in PMF (unadjusted hazard ratio, HR = 2.8, 95% confidence interval, CI (1.79-4.41), P < 0.001) and SMF (unadjusted HR = 2.55, 95% CI (1.1-5.71), P =0.025) and with shorter TTT in PMF (> 7 dL/g, unadjusted HR = 4.1, 95% CI (1.44-11.59), P = 0.009) patients. Associations with OS diminished in multivariate analyses after adjustments for the dynamic-international-prognostic-scoring-system (DIPSS) and myelofibrosis-secondary-to-PV-and ET-prognostic-model (MYSEC-PM), respectively. Association with TTT remained significant independently of JAK2 mutation, white blood cell count and chronic kidney disease.
Keywords: cancer; cardiovascular diseases; haematology; blood plasma; prognosis
