-
Cancer Control : Journal of the Moffitt... Jan 2015Platelet transfusion is a critical and often necessary aspect of managing cancer. Low platelet counts frequently lead to bleeding complications; however, the drugs used... (Review)
Review
BACKGROUND
Platelet transfusion is a critical and often necessary aspect of managing cancer. Low platelet counts frequently lead to bleeding complications; however, the drugs used to combat malignancy commonly lead to decreased production and destruction of the very cell whose function is essential to stop bleeding. The transfusion of allogeneic platelet products helps to promote hemostasis, but alloimmunization may make it difficult to manage other complications associated with cancer.
METHODS
The literature relating to platelet transfusion in patients with cancer was reviewed.
RESULTS
Platelet storage, dosing, transfusion indications, and transfusion response are essential topics for health care professionals to understand because many patients with cancer will require platelet transfusions during the course of treatment. The workup and differentiation of non-immune-mediated compared with immune-mediated platelet refractoriness are vital because platelet management is different between types of refractoriness.
CONCLUSIONS
A combination of appropriate utilization of platelet inventory and laboratory testing coupled with communication between those caring for patients with cancer and those providing blood products is essential for effective patient care.
Topics: Blood Platelets; Hemorrhage; Humans; Neoplasms; Platelet Count; Platelet Transfusion; Thrombocytopenia
PubMed: 25504278
DOI: 10.1177/107327481502200107 -
Revista Da Associacao Medica Brasileira... Jun 2018Obesity, diabetes and hypertension are risk factors for cardiovascular diseases (CVD) because they promote a state of hypercoagulability. It is known that platelets play... (Review)
Review
Obesity, diabetes and hypertension are risk factors for cardiovascular diseases (CVD) because they promote a state of hypercoagulability. It is known that platelets play an important role in the development of atherosclerosis. Recent studies have evaluated platelet volume indexes (PVIs) in individuals with risk factors for CVD to better understand the platelet mechanisms involved in their development. The IVPs indirectly estimate platelet function and are easily obtained from automated hematology analyzers, which provide platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and the platelet-large cell ratio (P-LCR). The present study aims to review literature studies that investigated the association between PVIs and obesity, diabetes, and arterial hypertension, in order to evaluate its use as a potential subclinical marker of CVD. Studies have shown promising results for MPV, an index that allows for early detection of platelet activation and may be useful in identifying patients before the onset of CVD development so that preventive strategies can be implemented. The PDW, although evaluated by a smaller number of studies, also showed promising results. However, there is still a long way to go in order for the MPV and PDW to be used in clinical practice, since there is still a need for more epidemiological evidence, establishing reference values, and standardizing the way results are presented.
Topics: Biomarkers; Blood Platelets; Cardiovascular Diseases; Diabetes Mellitus; Humans; Hypertension; Mean Platelet Volume; Obesity; Platelet Count; Risk Factors
PubMed: 30304315
DOI: 10.1590/1806-9282.64.06.554 -
JAMA Network Open Jan 2022Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is an indicator of cancer is...
IMPORTANCE
Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is an indicator of cancer is unclear.
OBJECTIVE
To evaluate the association of an elevated platelet count with a cancer diagnosis.
DESIGN, SETTING, AND PARTICIPANTS
This nested case-control study included Ontario residents enrolled in the provincial health insurance plan who had 1 or more routine complete blood count (CBC) tests performed between January 1, 2007, and December 31, 2017, with follow-up through December 31, 2018. Case patients were individuals with a new cancer diagnosis during the observation period. Eligible control individuals were cancer free before the date of diagnosis for a case patient to whom they were matched. One case patient was matched to 3 controls based on sex, age, and health care use patterns. Data were analyzed from September 24, 2020, to July 13, 2021.
EXPOSURES
Case patients and controls were assigned to 1 of 5 exposure groups based on age- and sex-specific platelet count distributions in the control population: very low (≤10th percentile), low (>10th to 25th percentile), medium (>25th to <75th percentile), high (75th to <90th percentile), and very high (≥90th percentile).
MAIN OUTCOMES AND MEASURES
Odds ratios (ORs) were estimated for specific cancer sites for each category of platelet count at intervals up to 10 years after a blood test.
RESULTS
Of the 8 917 187 eligible Ontario residents with a routine CBC record available, 4 971 578 (55.8%) were women; the median age at the first CBC was 46.4 years (IQR, 32.5-59.5 years). Among individuals with a routine CBC record available, 495 341 (5.6%) received a diagnosis of first primary cancer during the 10-year observation period. The OR for a solid tumor diagnosis associated with a very high platelet count vs a medium platelet count in the 6-month period before the diagnosis was 2.32 (95% CI, 2.28-2.35). A very high platelet count was associated with colon (OR, 4.38; 95% CI, 4.22-4.54), lung (OR, 4.37; 95% CI, 4.22-4.53), ovarian (OR, 4.62; 95% CI, 4.19-5.09), and stomach (OR, 4.27; 95% CI, 3.91-4.66) cancers. Odds ratios attenuated with increasing time from CBC test to cancer diagnosis.
CONCLUSIONS AND RELEVANCE
In this nested case-control study, an elevated platelet count was associated with increased risk of cancer at several sites. Our findings suggest that an elevated platelet count could potentially serve as a marker for the presence of some cancer types.
Topics: Adult; Biomarkers; Case-Control Studies; Female; Humans; Male; Middle Aged; Neoplasms; Ontario; Platelet Count
PubMed: 35015064
DOI: 10.1001/jamanetworkopen.2021.41633 -
Medicine Nov 2023The objective of this study was to ascertain the potential causal linkage between platelet (PLT) counts and the incidence of gastric cancer (GC). This study employed a...
The objective of this study was to ascertain the potential causal linkage between platelet (PLT) counts and the incidence of gastric cancer (GC). This study employed a 2-sample Mendelian randomization (MR) approach, utilizing the inverse variance weighting, weighted median, and MR-Egger regression methodologies. The publicly accessible summary statistics dataset from the genome-wide association study pertaining to individuals of European ancestry (n = 145,648) was employed as the foundational resource for the exposure variable. Concomitantly, the non-cancer disease codes for GC (n = 6563), derived from individuals within the UK Biosample Bank, were utilized as the outcome measure. A set of 132 single-nucleotide polymorphisms exhibiting genome-wide significance were selected as instrumental variables, drawn from the genome-wide association studies focused on PLT counts. The application of the weighted median methodology yielded indications suggesting the possible absence of a causal relationship between PLT counts and GC (beta = 0.139, SE = 0.079, P = .077). Contrarily, the implementation of the inverse variance weighting technique produced results indicative of a potential causal relationship between PLT counts and GC (beta = 0.128, SE = 0.049, P = .009). The assessment of Cochran Q test and the scrutiny of funnel plots unveiled no discernible indications of heterogeneity or asymmetry, thus signifying the absence of directional pleiotropy. The outcomes derived from the MR analysis lend credence to the hypothesis that there exists a plausible causal relationship between erythrocyte pressure and an elevated susceptibility to gastric cancer.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Platelet Count; Stomach Neoplasms; Causality; Polymorphism, Single Nucleotide
PubMed: 37933067
DOI: 10.1097/MD.0000000000035790 -
Thrombosis Research Mar 2023Platelets are primarily recognized for their role in hemostasis, but also regulate immune responses by interacting with leukocytes. Their highly sensitive nature enables...
Platelets are primarily recognized for their role in hemostasis, but also regulate immune responses by interacting with leukocytes. Their highly sensitive nature enables platelets to rapidly respond to micro-environmental changes, which is crucial under physiological condition but can jeopardize in vitro analyses. Thus, we tested how platelet count and changes in pH and temperatures, which are commonly experienced during inflammation and infection but also affected by ex vivo analyses, influence platelet-leukocyte interaction and immunomodulation. Reducing platelet count by up to 90 % slightly decreased platelet activation and platelet-leukocyte aggregate formation, but did not affect CD11b activation nor CD62L shedding of monocytes or neutrophils. Acidosis (pH 6.9) slightly elevated platelet degranulation and binding to innate leukocytes, though pH changes did not modulate leukocyte activation. While platelet responsiveness was higher at room temperature than at 37 °C, incubation temperature did not affect platelet-leukocyte aggregate formation. In contrast, platelet-mediated CD11b activation and CD62L expression increased with temperature. Our data thus demonstrate the importance of standardized protocols for sample preparation and assay procedure to obtain comparable data. Further, unspecific physiologic responses such as thrombocytopenia, acidosis or temperature changes may contribute to platelet dysfunction and altered platelet-mediated immunomodulation in inflammatory and infectious disease.
Topics: Humans; Temperature; Platelet Count; Hemostatics; Blood Platelets; Platelet Activation; Hemostasis; Leukocytes; Immunity; Acidosis; Hydrogen-Ion Concentration
PubMed: 36738664
DOI: 10.1016/j.thromres.2023.01.026 -
Platelets Apr 2021Platelets are damage sentinels of the intravascular compartment, initiating and coordinating the primary response to tissue injury. Severe trauma and hemorrhage induce... (Review)
Review
Platelets are damage sentinels of the intravascular compartment, initiating and coordinating the primary response to tissue injury. Severe trauma and hemorrhage induce profound alterations in platelet behavior. During the acute post-injury phase, platelets develop a state of impaired agonist responsiveness independent of platelet count, associated with systemic coagulopathy and mortality risk. In patients surviving the initial insult, platelets become hyper-responsive, associated with increased risk of thrombotic events. Beyond coagulation, platelets constitute part of a sterile inflammatory response to injury: both directly through release of immunomodulatory molecules, and indirectly through modifying behavior of innate leukocytes. Both procoagulant and proinflammatory aspects have implications for secondary organ injury and multiple-organ dysfunction syndromes. This review details our current understanding of adaptive and maladaptive alterations in platelet biology induced by severe trauma, mechanisms underlying these alterations, potential platelet-focused therapies, and existing knowledge gaps and their research implications.
Topics: Blood Platelets; Female; Humans; Male; Platelet Count; Wounds and Injuries
PubMed: 31986948
DOI: 10.1080/09537104.2020.1718633 -
Effects of Platelet Count on Blood Pressure: Evidence from Observational and Genetic Investigations.Genes Dec 2023Platelet count has been associated with blood pressure, but whether this association reflects causality remains unclear. To strengthen the evidence, we conducted a...
Platelet count has been associated with blood pressure, but whether this association reflects causality remains unclear. To strengthen the evidence, we conducted a traditional observational analysis in the Lifelines Cohort Study ( = 167,785), and performed bi-directional Mendelian randomization (MR) with summary GWAS data from the UK Biobank ( = 350,475) and the International Consortium of Blood Pressure (ICBP) ( = 299,024). Observational analyses showed positive associations between platelet count and blood pressure (OR = 1.12 per SD, 95% CI: 1.10 to 1.14 for hypertension; B = 0.07, 95% CI: 0.07 to 0.08 for SBP; B = 0.07 per SD, 95% CI: 0.06 to 0.07 for DBP). In MR, a genetically predicted higher platelet count was associated with higher SBP (B = 0.02 per SD, 95% CI = 0.00 to 0.04) and DBP (B = 0.03 per SD, 95% CI = 0.01 to 0.05). IVW models and sensitivity analyses of the association between platelet count and DBP were consistent, but not all sensitivity analyses were statistically significant for the platelet count-SBP relation. Our findings indicate that platelet count has modest but significant effects on SBP and DBP, suggesting causality and providing further insight into the pathophysiology of hypertension.
Topics: Humans; Blood Pressure; Cohort Studies; Platelet Count; Hypertension; UK Biobank
PubMed: 38137055
DOI: 10.3390/genes14122233 -
Clinical and Experimental Medicine Jun 2023The role of platelet function indices-platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), immature platelet fraction... (Meta-Analysis)
Meta-Analysis Review
The role of platelet function indices-platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), immature platelet fraction (IPF), and platelet mass index (PMI)-in psoriasis is uncertain. This systematic review and meta-analysis aimed to evaluate the association of these platelet biomarkers with both presence and severity of psoriasis. We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception to November 2021. To evaluate the association of platelet function indices and psoriasis, we recorded mean differences (MD) and 95% confidence intervals (CI) as well as correlation coefficients (r) for each included study, and generated summary estimates using random-effects inverse-variance modelling. We screened 1,079 unique studies, and included 33 studies with 6724 patients in the quantitative analyses. Compared with controls, patients with psoriasis had higher PLT (MD 12.86 × 10/L, 95% CI 6.34-19.39, p < 0.001), MPV (MD 0.61fL, 95% CI 0.31-0.92, p < 0.001), and PCT (MD 0.05%, 95% CI 0.01-0.09, p = 0.010), but similar PDW (MD 0.16%, 95% CI -0.46-0.79, p = 0.610). Psoriasis Area and Severity Index (PASI) was weakly correlated with PLT (r 0.17, 95% CI 0.06-0.28, p = 0.003), MPV (r 0.36, 95% CI 0.22-0.49, p < 0.001), and PDW (r 0.17, 95% CI 0.08-0.26, p < 0.001). Study numbers were insufficient to judge the relationship of IPF and PMI with psoriasis presence, or PCT, IPF, and PMI with psoriasis severity. In summary, PLT, MPV, and PCT are significantly elevated in patients with psoriasis, and PLT, MPV, and PDW are weakly correlated with PASI. Future studies are needed to evaluate the independent diagnostic and prognostic potentials of these biomarkers in patients with psoriasis.
Topics: Humans; Platelet Count; Blood Platelets; Mean Platelet Volume; Prognosis; Biomarkers
PubMed: 35377095
DOI: 10.1007/s10238-022-00820-5 -
Journal of Thrombosis and Haemostasis :... Nov 2021Severe postpartum hemorrhage (SPPH) is the leading cause of maternal mortality and morbidity worldwide. Platelet anomalies frequently occur during pregnancy. However,...
BACKGROUND
Severe postpartum hemorrhage (SPPH) is the leading cause of maternal mortality and morbidity worldwide. Platelet anomalies frequently occur during pregnancy. However, their role in the etiology of SPPH is largely unknown.
OBJECTIVE
To study the relation between platelet parameters and SPPH.
METHODS
This retrospective single-center cohort included deliveries between 2009 and 2017. SPPH was defined as ≥1000 ml blood loss within 24 h after delivery. Platelet parameters were measured within 72 h before delivery. Multiple imputation was performed for missing data. Odds ratios were adjusted (aORs) for maternal age, multiple gestation, macrosomia, induction of labor, preeclampsia, and hemolysis, elevated liver enzymes, and low platelets syndrome.
RESULTS
A total of 23 205 deliveries were included. Of the 2402 (10.4%) women with thrombocytopenia (<150 × 10 /L), 10.3% developed SPPH, compared with 7.6% of women with a normal platelet count (aOR: 1.34, 95% CI: 1.14-1.59). Women with a platelet count of <50 × 10 /L were most at risk (aOR of 2.24 [1.01-4.94]) compared with the reference group with normal platelet counts; the aOR was 1.22 (0.77-1.93) for the 50-99 × 10 /L platelet count group and 1.31 (1.10-1.56) for the 100-149 × 10 /L platelet count group. Plateletcrit was associated with SPPH (aOR 1.15 [1.08-1.21] per 0.05% decrease), and, although rarely present, a platelet distribution width (PDW) ≥23% (n = 22) also increased the odds of SPPH (aOR 6.05 [2.29-16.20]).
CONCLUSION
Different degrees of thrombocytopenia were independently associated with the occurrence of SPPH. Despite their relation to SPPH, plateletcrit and a PDW of ≥23% have limited additional value in addition to platelet count.
Topics: Cohort Studies; Female; Humans; Maternal Age; Platelet Count; Postpartum Hemorrhage; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 34339085
DOI: 10.1111/jth.15481 -
International Journal of Molecular... May 2021Hsia and collaborators [...].
Hsia and collaborators [...].
Topics: Animals; Biomedical Research; Blood Platelets; Disease; Health; Humans; Platelet Aggregation Inhibitors; Platelet Count; Regenerative Medicine
PubMed: 34067024
DOI: 10.3390/ijms22094968