High platelet-to-lymphocyte ratio may differentiate polycythemia vera from secondary polycythemia

Krečak, Ivan; Holik, Hrvoje; Perić, Martina Morić; Zekanović, Ivan; Coha, Božena; Gverić–Krečak, Velka; Lucijanić, Marko

doi:10.1007/s00508-022-02027-w

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…Recently, there has been growing interest in the diagnostic utility of blood count parameters in patients with erythrocytosis. Some studies have reported that potential of indices such as neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, demonstrating significantly higher values in PV patients compared to those with secondary erythrocytosis [ 29 , 30 ]. We analyzed the differences of these indices between patients with and without reportable mutations.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Approaches to Investigate JAK2-Unmutated Erythrocytosis Based on a Single Tertiary Center Experience

Lee,

Seo,

Kim

et al. 2024

Mol Diagn Ther

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Introduction Erythrocytosis is attributed to various clinical and molecular factors. Many cases of JAK2 -unmutated erythrocytosis remain undiagnosed. We investigated the characteristics and causes of JAK2 -unmutated erythrocytosis. Methods We assessed the clinical and laboratory results of patients with erythrocytosis without JAK2 mutations and performed targeted next-generation sequencing (NGS) panels for somatic and germline mutations. Results In total, 117 patients with JAK2 -unmutated erythrocytosis were included. The median hemoglobin and hematocrit levels were 17.9 g/dL and 53.4%, respectively. Erythropoietin levels were not below the reference range. Thrombotic events were reported in 17 patients (14.5%). Among JAK2 -unmutated patients, 44 had undergone targeted panel sequencing consisting of myeloid neoplasm-related genes, and 16 had one or more reportable variants in ASXL1 (5/44), TET2 , CALR , FLT3 , and SH2B3 (2/44). Additional testing for germline causes revealed eight variants in seven genes in eight patients, including NF1 , BPGM , EPAS1 , PIEZO1 , RHAG , SH2B3 , and VHL genes. One NF1 pathogenic, one BPGM likely pathogenic, and six variants of undetermined significance were detected. Conclusion Somatic and germline mutations were identified in 36.4% and 33.3 % of the JAK2 -unmutated group; most variants had unknown clinical significance. Not all genetic causes have been identified; comprehensive diagnostic approaches are crucial for identifying the cause of erythrocytosis.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Approaches to Investigate JAK2-Unmutated Erythrocytosis Based on a Single Tertiary Center Experience

Lee,

Seo,

Kim

et al. 2024

Mol Diagn Ther

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“…PLR is also meaningful for diagnosis of PV. 17,19 Panmyelosis, which is essential for the diagnosis of PV, increases the neutrophil and platelet counts and decreases the proportion of lymphocytes. Consequently, PV patients have a higher NLR & PLR, resulting in disparities between them and SP patients.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, shorter OS and higher risk of thrombosis are associated with a higher NLR in patients with PV 17,18 PLR and NLR are known to have similar mechanisms. PLR is also meaningful for diagnosis of PV 17,19 …”

Section: Discussionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as new possible minor criteria for diagnosis of polycythemia vera

Kim

Kwon

et al. 2023

Int J Lab Hematology

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IntroductionThe role of inflammation in the pathophysiology of polycythemia vera (PV) is important. The presence of JAK2 mutations is important in the diagnosis of PV, and serum levels of erythropoietin (EPO) also play a supporting role. However, serum EPO levels show some limitations. The neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) are a readily available marker of inflammation. Thus, we examined whether NLR & PLR might diagnose PV in erythrocytosis patients. We compared NLR & PLR and EPO diagnostic values.MethodsWe retrospectively reviewed clinical and laboratory data from two referral hospitals. Two hundred and eighty‐five patients with erythrocytosis who underwent a test for the JAK2 mutation were included. It wac classified as the PV group and the secondary polycythemia (SP) group.ResultsThe median NLR & PLR in the PV group (n = 70) was significantly higher than that in the SP group (n = 170) (NLR: 6.04 vs. 1.77, PLR: 283.18 vs. 101.56, respectively, p < 0.001). In the receiver operating characteristic analysis, the area under the curve of NLR & PLR was significantly higher than that of serum EPO (NLR vs EPO: 0.921 vs. 0.827, p = 0.003; PLR vs EPO: 0.917 vs 0.827, p = 0.003).ConclusionIn conclusion, NLR & PLR were higher in PV than in SP and showed better diagnostic value than serum EPO level, highlighting their potential as minor diagnostic criteria in patients with PV.

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“…PV can cause significant cardiovascular morbidities and mortality [6]. It is extremely important to distinguish PV from SP, as the treatment approaches for these two conditions are very different and particularly because delayed diagnosis might lead to poor outcomes in subjects with PV [7]. Although previous studies support the effectiveness of low erythropoietin (EPO) in differentiating PV from SP [8,9], EPO is a minor indicator with low discriminatory sensitivity [10].…”

Section: Introductionmentioning

confidence: 99%

“…Defective stem cell clones in MPN cause cytokine elevation, thereby perpetuating the inflammatory activity [13]. Some recent studies have shown that cheap and accessible inflammation indices such as the neutrophilto-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) can distinguish PV from SP, and they have claimed that these markers may be utilized in PV diagnosis [3,7]. However, the evidence supporting these claims is limited.…”

Section: Introductionmentioning

confidence: 99%

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

Gulturk,

Kapucu

2024

JPM

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Aim: To investigate inflammation indices and erythropoietin levels for their potential role in distinguishing polycythemia vera from secondary polycythemia and to compare different parameter combinations in terms of the diagnostic accuracy. Methods: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria (n = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia (n = 84). Results: The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group (p < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone. Conclusion: These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.

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High platelet-to-lymphocyte ratio may differentiate polycythemia vera from secondary polycythemia

Cited by 11 publications

References 14 publications

Diagnostic Approaches to Investigate JAK2-Unmutated Erythrocytosis Based on a Single Tertiary Center Experience

Diagnostic Approaches to Investigate JAK2-Unmutated Erythrocytosis Based on a Single Tertiary Center Experience

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as new possible minor criteria for diagnosis of polycythemia vera

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

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