Mean platelet volume as a predictive marker for venous thromboembolism in patients treated for Hodgkin lymphoma

Abstract

Mean platelet volume (MPV) is reported to be associated with the risk of venous thromboembolism (VTE) and mortality in patients with cancer.We sought to determine the association of MPV with symptomatic VTE occurrence in patients treated for newly diagnosed Hodgkin lymphoma (HL) and their outcomes. We retrospectively studied 167 consecutive adult patients treated with HL. During first-line treatment 12 (7.2%) patients developed VTE and 14 (8%) died within the observation period. The pre-chemotherapy values of MPV were significantly lower in VTE patients than those without (p=0.0343). Patients with MPV≤25th percentile (6.8 fl) had an increased risk of VTE occurrence (p=0.0244). In multivariate analysis, MPV≤25th percentile (OR 2.21; 95%CI 1.07-4.57, p=0.033), advanced stage (OR 2.08; 95%CI 1.06-4.07, p=0.033) and bulky disease (OR 2.23; 95%CI 1.16-4.31, p=0.016) were significant factors for developing VTE. Only the impact of MPV≤25th percentile on VTE-free survival rates was found. VTE occurred in 43% (n=3) of the high-risk patients of the Thrombosis Lymphoma (ThroLy) score and in 17% (n=2) of the high-risk of the Khorana Risk Score (KRS). Neither the KRS nor the ThroLy score could identify patients at a high risk of VTE with a high degree of accuracy. We expanded the ThroLy score with the addition of the MPV≤25th percentile to more accurately identify HL patients with a higher risk of VTE.Our study indicates that the pre-chemotherapy MPV value, while of no use as an overall prognosis predictor, may still represent a useful prognostic marker for a significant VTE risk especially when incorporated into VTE-risk assessment models.

High mean platelet volume and neutrophil-to-lymphocyte ratio are predictors of mortality in patients with HIV-related non-Hodgkin’s lymphoma

“…Our study is the first to show that a high MPV is a predictor of poor outcomes in patients with NHL and HIV, even controlling for IPI and histological subtype of lymphoma. These results are similar to those reported by Rupa-Matysek in patients with Hodgkin's lymphoma, who found a trend to better survival in patients with low MPV (<6.8 fL), although this finding did not reach statistical significance (log rank test =1.124, p =0.2610) [33]. However, our results are opposite to what Rupa-Matysek et al reported in patients with diffuse large B-cell lymphoma and without HIV.…”

Venous Thromboembolism in Lymphoma: Risk Stratification and Antithrombotic Prophylaxis

“…Another emerging parameter is the mean platelet volume (MPV) [42,43]. A lower MPV has been associated with the risk of VTE in cohorts of patients with DLBCL and HL, however, with varying cut-points [44,45].…”

The prognostic value of mean platelet volume in cancer patients

“…Patients with baseline MPV 6.8 fL or below more often developed VTE compared to patients with higher MPV values (19% vs. 5.5%, p = 0.0244). Of the HL patients, in both the univariate and multivariate models, the patients with baseline low MPV levels had an above twofold increased risk of VTE development [29].…”