Limits...
TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders.

Palmblad J, Björkholm M, Kutti J, Lärfars G, Löfvenberg E, Markevärn B, Merup M, Mauritzson N, Westin J, Samuelsson J, Birgegård G - Int J Med Sci (2008)

Bottom Line: At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures.For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly.There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts.

View Article: PubMed Central - PubMed

Affiliation: Hematology Center, Karolinska University Hospital Huddinge, Stockholm, Sweden. jan.palmblad@ki.se

ABSTRACT
Anagrelide is often used in the treatment of thrombocythemia in myeloproliferative disease (MPD), but information concerning effects of treatment on cytokines involved in regulation of blood platelet levels is limited. Here, we investigated serum levels of thrombopoietin (TPO) and soluble IL-6 receptor (sIL-6R) in relation to response to treatment with and plasma concentrations of anagrelide. Samples from 45 patients with thrombocythemia due to MPD (ET=31, PV=14), being treated with anagrelide for 6 months, were analyzed for TPO, sIL-6R and anagrelide levels. The mean baseline platelet count was 983x10(9)/L. A reduction of platelets to <600 in asymptomatic or <400 x 10(9)/L in symptomatic patients was defined as a complete remission (CR), a reduction with >50% of baseline as partial remission, and <50% reduction as failure. At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures. For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly. There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts. Thus, a pronounced increase of TPO levels after 6 months of anagrelide treatment indicated that this treatment affected a major regulatory mechanism for megakaryocyte and platelet formation in MPD.

Show MeSH

Related in: MedlinePlus

Changes at 6 months in platelet counts, TPO and sIL-6R concentrations in all MPD patients (All), in those achieving complete response (CR) and those attaining partial response or failure of response (PR+F), in relation to values prior to start of anagrelide.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2293642&req=5

Figure 1: Changes at 6 months in platelet counts, TPO and sIL-6R concentrations in all MPD patients (All), in those achieving complete response (CR) and those attaining partial response or failure of response (PR+F), in relation to values prior to start of anagrelide.

Mentions: The starting venous blood platelet counts for the 45 patients of the ET and the PV groups are given in Table 1, together with the platelet counts at 6 months. All 45 patients displayed a similar drop of the platelet count (Table 1). At start, there was no difference for the platelet counts for those achieving CR and those who did not (982 x 109/L for both groups). The drop of the platelet count over the 6 months was 50.3 % for all 45 MPD patients, 56.6 % for patients achieving CR and 29.4 % for the PR and F group (Figure 1). At 6 months, the difference between the CR and the PR+F groups (424±115 vs. 694±282) was statistically significant (P<0.01).


TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders.

Palmblad J, Björkholm M, Kutti J, Lärfars G, Löfvenberg E, Markevärn B, Merup M, Mauritzson N, Westin J, Samuelsson J, Birgegård G - Int J Med Sci (2008)

Changes at 6 months in platelet counts, TPO and sIL-6R concentrations in all MPD patients (All), in those achieving complete response (CR) and those attaining partial response or failure of response (PR+F), in relation to values prior to start of anagrelide.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2293642&req=5

Figure 1: Changes at 6 months in platelet counts, TPO and sIL-6R concentrations in all MPD patients (All), in those achieving complete response (CR) and those attaining partial response or failure of response (PR+F), in relation to values prior to start of anagrelide.
Mentions: The starting venous blood platelet counts for the 45 patients of the ET and the PV groups are given in Table 1, together with the platelet counts at 6 months. All 45 patients displayed a similar drop of the platelet count (Table 1). At start, there was no difference for the platelet counts for those achieving CR and those who did not (982 x 109/L for both groups). The drop of the platelet count over the 6 months was 50.3 % for all 45 MPD patients, 56.6 % for patients achieving CR and 29.4 % for the PR and F group (Figure 1). At 6 months, the difference between the CR and the PR+F groups (424±115 vs. 694±282) was statistically significant (P<0.01).

Bottom Line: At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures.For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly.There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts.

View Article: PubMed Central - PubMed

Affiliation: Hematology Center, Karolinska University Hospital Huddinge, Stockholm, Sweden. jan.palmblad@ki.se

ABSTRACT
Anagrelide is often used in the treatment of thrombocythemia in myeloproliferative disease (MPD), but information concerning effects of treatment on cytokines involved in regulation of blood platelet levels is limited. Here, we investigated serum levels of thrombopoietin (TPO) and soluble IL-6 receptor (sIL-6R) in relation to response to treatment with and plasma concentrations of anagrelide. Samples from 45 patients with thrombocythemia due to MPD (ET=31, PV=14), being treated with anagrelide for 6 months, were analyzed for TPO, sIL-6R and anagrelide levels. The mean baseline platelet count was 983x10(9)/L. A reduction of platelets to <600 in asymptomatic or <400 x 10(9)/L in symptomatic patients was defined as a complete remission (CR), a reduction with >50% of baseline as partial remission, and <50% reduction as failure. At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures. For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly. There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts. Thus, a pronounced increase of TPO levels after 6 months of anagrelide treatment indicated that this treatment affected a major regulatory mechanism for megakaryocyte and platelet formation in MPD.

Show MeSH
Related in: MedlinePlus