Problems of Radiation Medicine and Radiobiology

Mishcheniuk О. Yu., Klymenko S. V.

Predictive value of laboratory-hematological parameters for thromboses development in patients with spontaneous and radiation-associated Ph-negative myeloproliferative neoplasms

Objective. To establish which of hematological parameters have discriminatory ability for forecast the development of thromboses in spontaneous and radiation-associated Ph-negative myeloproliferative neoplasms (MPN).
Materials and methods. It was analyzed hematological parameters of 85 patients with polycythemia vera (PV), 43 – essential thrombocythemia (ET) and 40 – primary myelofibrosis (PMF). The main group consisted of patients (PV = 18,  ET = 6, PMF = 18) which were exposed to ionizing radiation due to the Chornobyl accident, and control – patients (PV = 67, ET = 37, PMF = 22) without affecting emergency radiation in history.
Results. It was determined, that in spontaneous PV predictive for the thromboses development value of the hematocrit and the leukocytes is > 55 % and > 13.2 · 109/l respectively, and the total cholesterol is > 5.7 mmol/l. The efficiency such factor as the “hematocrit > 55 %” (area under the curve – AUC = 0.67; p = 0.023) and the “leukocytes > 13.2 · 109/l “(AUC = 0.66; p = 0.011) is average for the predicting of thromboses, and the “total cholesterol > 5.7 mmol/l” (AUC = 0.92; p <0.0001) is excellent. In radiation-associated PV and spontaneous ET predictor of thromboses was the platelet count < 440.0 · 109/l and the leukocytes > 10.0 · 109/l respectively, and it characterized by very good (AUC = 0.84; p = 0.0002 and AUC = 0.72, p = 0.019, respectively) predictive power. In the main and in the control group of PV patients was determined the same AUC for application the “hematocrit> 55 %” (p = 0.800) and the “leukocytes > 13.2 · 109/l” (p = 0.831) in the thromboses prediction, but it was calculated different AUC for the “platelets < 440.0 · 109/l” (p = 0.0004). Therefore, the use such PB index as the “platelets < 440.0 · 109/l” for the thromboses risk assessment is appropriate only in PV patients with a history of radiation, the “hematocrit < 55 %”, the “leukocytes < 13.2 · 109/l” – in the patients who suffered from the Chornobyl accident and in the persons affected by IR exclusively within the natural background radiation. In the main and in the control group of patients with ET is no difference between the AUC of the factor “leukocytes > 10.0 · 109/l” (p = 0.509), so it can be used at spontaneous and radiation-related ET.

Key words. The Chornobyl nuclear power plant, ionizing radiation, myeloproliferative neoplasm, hematological laboratory characteristics.

Problems of radiation medicine and radiobiology. 2015;20:376-398.