12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
tion is probably absent in the healthy population. Aims. Since PV-patients
are at increased risk for VTE, we set out to investigate whether the
JAK2-V617F mutation constitutes a risk factor for VTE in non-PV
patients. Methods. The presence of the JAK2-V617F mutation was retrospectively
assessed in 188 consecutive patients with objectively diagnosed
deep venous thrombosis (DVT), using a quantitative ASO Taqman
PCR. Clinical parameters of mutation-positive patients at the time
of DVT were analyzed. Results. Of the 188 samples, 180 (96%) were
evaluable. A positive signal was observed in 6 VTE patients (3.3%).
Quantitative analysis revealed that between 0.12 and 1.0% of cells were
JAK2-V617F positive. Sensitive measurement of samples from agematched
healthy blood bank donors is currently being performed and
will be presented at the meeting. Conclusions. We found the JAK2-V617F
mutation in 3.3% (95%CI 1.5-7.0) of DVT patients, who did not fulfill
diagnostic PV criteria. It is possible that in these patients DVT is a first
symptom of a myeloproliferative syndrome. Investigation in an appropriate
control group will determine the strength of this relationship.
0351
A PROPOSAL OF SCORING SYSTEM IN ASSESSMENT OF THROMBOTIC RISK IN CANCER
PATIENT. A MONOCENTRIC STUDY
G. Giordano, G. Farina, R. Tambaro, M. Specchia, S. Papini,
M. Piunno, C. Antonelli, B. Zappacosta, S. Storti
UCSC Campobasso, CAMPOBASSO, Italy
Background. Deep venous thrombosis (DVT) is present in about 3-15%
of cancer patient. Paraneoplastic thrombosis pathogenesis is multifactorial.
Antithrombotic prophylaxis frequently is not oriented to real thrombotic
or haemorragic risk of patient. Aims. Aim of our study is to define
the real thrombotic risk in neoplastic patient. With this purpose we considered
in our patient complement fraction C3 and C4 and immune circulating
complex (ICC) because they activate macrophage and platelets
and increase tissue factor level. Moreover we recognize also total cholesterol
and triglycerides level, because they are linked with factor VII activation.
Methods. We considered C3, C4, ICC, cholesterol and triglycerides
level in 92 patients with solid neoplasm (52 colon, 20 lung, 10 gastric,
10 others) and without anticoagulant prophilaxis. Of these only 76
were evaluable because in these complete data were available. Median
age was 67.5 years (R 57-83). M/F ratio was 55/37. The threshold value
of third quartile was chosen as risk cut-off (C3: 130 mg/dL; C4: 32 mg/dl;
ICC: 2.9 mcg/mL; total cholesterol: 205 mg/dL; triglycerides 123 mg/dL).
We elaborate a scoring system in which 1 point was attributed to each
value inferior to third quartile. The statistical analysis was conducted
with Yates corrected chi square test, Odds Ratio (OR), realtive risk (RR).
Results. 15 patients (16%) showed DVT. Of these 12(80%) had a score
inferior/equal to 3 and 3 superior/equal to 4. 77 patients (84%) did not
show DVT. Of these 35 (46%) had a score superior/equal to 4 and 26 inferior/equal
to 3. Yates corrected chi square test is 5.1 (p 0.02), with an OR
of 5.4 (95%CI 1.4-21) and a RR of 4 (95%CI 1.2-13). Negative predictive
value is 0.57 (95%CI 0.52-0.60) and positive predictive value is 0.80
(95%CI 57-93). Sensitivity was 0.32 (95%CI 0.23-0.37) and specificity
was 0.92 (95%CI 0.83-0.97). Summary and conclusions. Neoplastic patient
frequently shows haemorragic risk (eg in chemotherapy induced thrombocytopenia).
Therefore antithrombotic prophylaxis should be used considering
the effective thrombotic and haemorragic risk of neoplastic
patient. Our scoring system is useful in distinguishing cancer patient with
low thrombotic risk and consent to avoid antithrombotic prophylaxis in
patient with higher bleeding and lower thombotic risk. Nevertheless
these data need confirmation on a larger cohort of patients.
0352
PLASMA THROMBOMODULIN: A POTENTIAL MARKER FOR PRE-ECLAMPSIA
B. Lwaleed, 1 L. Dusse, 2 M. Carvalho, 2 D. Voegeli, 3 A. Cooper, 4
B. Lwaleed3 1 Southampton University Hospitals NHS Tru, SOUTHAMPTON, United
Kingdom; 2 Federal University of Minas Gerais, MINAS GERAIS, Brazil; 3 University
of Southampton, SOUTHAMPTON, United Kingdom; 4 Portsmouth
University, PORTSMOUTH, United Kingdom
Background. Thrombomodulin (TM) is an endothelial cell membrane
glycoprotein which functions as a thrombin receptor. The thrombinthrombomodulin
complex initiates the protein C anticoagulant pathway.
It activates protein C rapidly which together with protein S can
inactivate factor Va and factor VIIIa. Pre-eclampsia (P-Ec) is a complex
multisystem disorder characterized by hypertension, proteinuria and
126 | haematologica/the hematology journal | 2007; 92(s1)
edema. It occurs after the 20th week of pregnancy. P-Ec has no cure,
except by pregnancy interruption. In more severe cases, conditions such
as eclampsia and HELLP syndrome (hemolysis, elevated liver enzyme,
low platelets) or DIC (disseminated intravascular coagulation) may
develop. Aims. To quantify plasma TM levels in pre-eclamptic women
and compare these to the plasma TM levels in non-pregnant women and
healthy pregnant women. Methods. Plasma TM levels were measured
using an enzyme-linked immunosorbent assay (ELISA). A total of 57
subjects were studied. These include non-pregnant women (n=22),
healthy pregnant women (n=15), and pre-eclamptic women (n=20), at
the third trimester. Results. The mean and standard deviation (mean±SD)
for the three groups were: non pregnant women (0.609±0.311), healthy
pregnant women (0.692±0.267) and pre-eclamptic women
(0.917±0.324). Plasma TM levels showed a statistically significant difference
when women with pre-eclampsia were compared to the non-pregnant
women group (p