The expression pattern of c-mpl in megakaryocytes correlates with thrombotic risk in essential thrombocythemia

Luciana Teofili, Francesco Pierconti, Annalaura Di Febo, Nicola Maggiano, Nicola Vianelli, Stefano Ascani, Elena Rossi, Stefano Pileri, Giuseppe Leone, Luigi Maria Larocca, Valrio De Stfano

Research output: Contribution to journalArticlepeer-review

Abstract

Using immunohistochemistry, we investigated the expression of c-mpl in bone marrow megakaryocytes of 88 patients with essential thrombocythemia (ET), 6 patients with secondary thrombocytosis (ST), and 20 patients with lymphoma (controls). Considering both the pattern of expression and the staining intensity, we identified a uniform and a heterogeneous pattern of c-mpl expression. The uniform pattern was found in all the controls, all the patients with ST, and 28 of the patients with ET, with a strong staining intensity observed in most megakaryocytes (> 80%). In contrast, c-mpl expression was heterogeneous in 60 patients with ET, 18 of whom (30%) presented with thrombosis at diagnosis, a significant difference from patients with a uniform c-mpl pattern (2 of 28; 7%; P = .026). In particular, the overrepresentation of thrombotic complications in patients with a heterogeneous c-mpl expression pattern was found mainly among patients with a significant percentage (10% to 40%) of weakly stained or c-mpl-negative megakaryocytes (heterogeneous-weak pattern; 13 of 30; 43%; P = .002). Accordingly, this pattern was associated with a 6.1-fold increased risk of thrombosis compared with that of patients with a uniform c-mpl pattern. In conclusion, the presence of a heterogeneous pattern of c-mpl distribution in bone marrow megakaryocytes could be a useful diagnostic criterion in the differential diagnosis of thrombocytosis. Furthermore, detection of a significant percentage of weakly stained or c-mpl-negative megakaryocytes can identify patients with a higher risk of thrombosis.

Original languageEnglish
Pages (from-to)714-717
Number of pages4
JournalBlood
Volume100
Issue number2
DOIs
Publication statusPublished - Jul 15 2002

ASJC Scopus subject areas

  • Hematology

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