Symptoms
The life expectancy of patients with essential thrombocytosis (primary thrombocythemia) is nearly that of the healthy population. Median survival is approximately 20 years. For patients younger than age 60 years, median survival is 33 years.
Causes
Things that may be linked to shorter survival time are:
- Accelerated, or blast, phase
- Enlarged spleen
- Areas of bone damage from the leukemia’s growth
- An increased number of basophils and eosinophils (certain types of cells) in blood samples
- Very high or very low platelet counts
- Age 60 or older
- Several chromosomal changes in the CML cells
Prevention
- Infection. A series of acute and chronic infection has been associated with reactive thrombocytosis. ...
- Inflammatory diseases. ...
- Iron deficiency anemia. ...
- Malignant disease. ...
- Splenectomy. ...
- Chronic myeloid leukemia. ...
- Polycythemia vera. ...
- Agnogenic myeloid metaplasia. ...
- Essential thrombocytosis. ...
Complications
- Headache
- Dizziness or lightheadedness
- Chest pain
- Weakness
- Numbness or tingling of the hands and feet
What is the life expectancy of someone with essential thrombocythemia?
Why does CML cause thrombocytosis?
What causes elevated platelet count?
What causes essential thrombocythemia?
What cancers cause thrombocytosis?
Thrombocytosis can be a marker for potential cancer, including lung, endometrial, gastric, oesophageal, or colorectal cancer. The causes of thrombocytopenia are diverse, but can be considered as arising from three main causes: Reduced platelet production as a result of marrow-based disorders.
Is thrombocytosis serious?
Thrombocythemia and thrombocytosis may cause blood clots which can block blood flow to your organs. This can lead to the following serious complications: Venous thromboembolism. Stroke and transient ischemic attacks.
Can you have high platelets without having cancer?
Sometimes high platelet levels are triggered by an infection, medications, low iron levels, or physical activity. Having high platelets doesn't always cause symptoms, but some may experience complications such as blood clots. High platelets may also point to certain kinds of cancer.
How often is thrombocytosis cancer?
Overall, 7.1% (95% CI, 6.6%-7.5%) of the men with thrombocytosis and 4.9% (95% CI, 4.6%-5.1%) of the women with thrombocytosis received a diagnosis of a solid cancer within 2 years of the index date.
Can you live a normal life with thrombocytosis?
The life expectancy of patients with essential thrombocytosis (primary thrombocythemia) is nearly that of the healthy population. Median survival is approximately 20 years. For patients younger than age 60 years, median survival is 33 years.
What is the most common cause of thrombocytosis?
Essential thrombocythemia (ET) was the most common cause of primary thrombocytosis. Among secondary, non-infectious etiologies, tissue damage was the most common, followed by malignancy and iron-deficiency anemia. The most common infectious causes of thrombocytosis were soft-tissue, pulmonary and GI infections.
How do you treat thrombocytosis?
Your doctor might prescribe platelet-lowering drugs primarily in the form of hydroxyurea (Droxia, Hydrea) or interferon alfa (Intron A). Platelets can be removed from your blood by a procedure that's similar to dialysis.
Is there a cure for essential thrombocytosis?
Although there's no cure for essential thrombocythemia, treatments can control symptoms and reduce the risk of complications. Life span is expected to be normal despite the disease. Treatment of essential thrombocythemia depends on your risk of blood clots or bleeding episodes.
What are the symptoms of thrombocytosis?
SymptomsHeadache.Dizziness or lightheadedness.Chest pain.Weakness.Numbness or tingling of the hands and feet.
Can thrombocytosis lead to leukemia?
In rare cases, essential thrombocytosis develops into polycythemia vera (PV), myelofibrosis, a myelodysplastic syndrome or acute myelogenous leukemia (AML).
Does high platelets mean leukemia?
This condition is more common in solid tumors like lung cancer, hepatocellular (liver) carcinoma, ovarian cancer, and colorectal cancer. Elevated platelet counts can also be seen in chronic myelogenous leukemia (CML).
What is reactive thrombocytosis?
It's called reactive thrombocytosis or secondary thrombocytosis when the cause is an underlying condition, such as an infection. Less commonly, when thrombocytosis has no apparent underlying condition as a cause, the disorder is called primary thrombocythemia or essential thrombocythemia. This is a blood and bone marrow disease.
How to detect thrombocytosis?
Your doctor might detect thrombocytosis in a routine blood test result that shows a high platelet level. If your blood test indicates thrombocytosis, it's important to determine whether it's reactive thrombocytosis or essential thrombocythemia to know how to manage the condition.
What is the stem cell in the bone?
Bone marrow — spongy tissue inside your bones — contains stem cells that can become red blood cells, white blood cells or platelets. Platelets stick together, helping blood to form a clot that stops bleeding when you damage a blood vessel, such as when you cut yourself. Thrombocytosis occurs when your body produces too many platelets.
What is the role of platelets in blood clots?
Platelets are blood particles produced in the bone marrow that play an important role in the process of forming blood clots. Thrombocytosis (throm-boe-sie-TOE-sis) is a disorder in which your body produces too many platelets.
Why is my bone marrow abnormal?
The cause of this disorder is unclear but it often appears to be connected to mutations in a variety of genes. Your bone marrow produces too many of the cells that form platelets and these platelets are often abnormal. This poses a much higher risk of clotting or bleeding complications than does reactive thrombocytosis.
What causes a person to lose blood faster than it produces?
Iron deficiency. Removal of your spleen. Hemolytic anemia — a type of anemia in which your body destroys red blood cells faster than it produces them, often due to certain blood diseases or autoimmune disorders. Inflammatory disorders, such as rheumatoid arthritis, sarcoidosis or inflammatory bowel disease.
Do people with thrombocytosis have symptoms?
People with thrombocytosis often don't have signs or symptoms. Signs and symptoms of reactive thrombocytosis, if they do occur, relate to the underlying condition.
What causes thrombocytosis in children?
The most common causes of thrombocytosis are iron deficiency, inflammation due to other conditions, and acute infections (for example, pneumonia, especially in children). Myeloproliferative diseases, ET and PV are not uncommon, each present in about 1 in 100,000 individuals in the population.
What causes reactive thrombocytosis?
The second major cause of reactive thrombocytosis is inflammation; usually, the symptoms and signs of rheumatoid arthritis, inflammatory bowel disease, and cancer, the leading causes of inflammation induced reactive thrombocytosis, are obvious. In such cases, treatment of the underlying disorder is called for, and if successful, ...
What other clinical manifestations may help me to diagnose thrombocytosis?
Most patients with PV or ET are asymptomatic, but a ruddy complexion (in PV), early satiety (due to splenomegaly, in PV or ET), erythromelalgia (pain in the distal extremities, in PV), or pruritis (due to basophils, in PV or ET) can indicate a myeloproliferative disease.
What is the standard deviation for thrombocytosis?
What every physician needs to know: Thrombocytosis is defined as a platelet count greater than two standard deviations above normal, or above 400,000 per microliter in most clinical laboratories. In approaching a patient with an elevated platelet count, the clinician must first verify that the count is elevated consistently.
What does elevated red cell count mean?
An elevated red cell count could indicate PV, as inflammation and iron deficiency both cause anemia , and an examination of the red cell mean corpuscular volume (MCV) is important, as a patient with PV who is also iron deficient (such patients have an increased incidence of gastrointestinal bleeding) may present with normal or low red cell counts, and only with thrombocytosis.
Is bone fide thrombocytosis a primary cause?
This “distributive” thrombocytosis is rarely of any consequence to the patient. In contrast, bone fide thrombocytosis is usually due either to a primary marrow disease of excess myeloproliferation, usually polycythemia vera (PV) or essential thrombocythemia (ET), or is far more commonly reactive, usually due to iron deficiency or inflammation.
Is platelet count inconsequential?
For most patients with thrombocytosis, the elevated platelet count is inconsequential, and the patient’s prognosis dependent entirely on the underlying cause of marrow reactivity (iron deficiency, inflammation). In patients with myeloproliferative disorders (PV, ET most common), prognosis is usually good, with minimal impact on survival in most patients, especially since these disorders are more common in older individuals.
How do platelets contribute to hemostasis?
They have a unique mechanism of derivation as fragments from the cytoplasm of bone marrow megakaryocytes in a process called thrombopoiesis [1]. The cytokine thrombopoietin stimulates platelet production through ligation of its cognate surface receptor c-Mpl. Other signals also contribute to thrombopoiesis including SDF1 (stem cell derived factor 1, also called CXCL12) ligating receptor CXCR4, integrins and PF4 (platelet factor 4). Support is lent to megakaryocytes by the bone marrow microenvironment in the form of both soluble factors and of direct cell-cell interactions with specialized resident stromal cells[2]. Platelets are derived from proplatelets which represent long protrusions of the mature magakaryocyte cytoplasm[3]. Abnormalities in platelet number, either increase (thrombocytosis) or decrease (thrombocytopenia) accompany diverse pathologic conditions and may aid in their diagnosis[4]. An elevated platelet count has various causes and is either primary due to essential thrombocytosis or other myeloproliferative disorders or secondary to malignancy, infection, chronic inflammation, trauma or surgery, iron deficiency and splenectomy. The common denominator of most of these secondary conditions is inflammation[5]. Inflammatory cytokines stimulate the process of platelet production by megakaryocytes in the bone marrow. Cancer is a pathology that is often associated with thrombocytosis. This relates to the cytokine milieu of several malignancies that stimulates thrombopoiesis. Possibly due to this fact of association with a particular cytokines setting, thrombocytosis has been found to be an adverse prognostic factor in many common malignancies. Thrombocytosis appears to be a universal marker of adverse outcomes in cancer. Its association with worse oncologic outcomes has been reported in early and advanced breast cancer[6,7], ovarian cancer[8,9], genitourinary cancers[10,11] and several other types[12,13].
What are platelets derived from?
Platelets are derived from proplatelets which represent long protrusions of the mature magakaryocyte cytoplasm[3]. Abnormalities in platelet number, either increase (thrombocytosis) or decrease (thrombocytopenia) accompany diverse pathologic conditions and may aid in their diagnosis[4].
Is thrombocytosis a predictive factor for anti-VEGF?
It remains to be seen if thrombocytosis could be a predictive factor for anti-VEGF therapies in gastrointestinal cancers and in particular colorectal cancer and hepatocellular carcinoma where the anti-VEGF monoclonal antibody bevacizumab and the small molecule inhibitor sorafenib are clinically used[65,66]. Footnotes.
Is thrombocytosis associated with age?
In another study which included mainly patients with squamous carcinomas but also a minority (7%) with esophageal adenocarcinomas, thrombocytosis, defined this time as platelets more than 400 × 109/L, was present in 4% of patients and it was not associated with age, gender, location along the esophagus, degree of differentiation, lymphovascular or perineural invasion or node involvement[37]. It was observed more often in patients with adenocarcinoma and correlated with tumor size. Although this report did not study thrombocytosis as it pertains to prognosis, either overall or progression free survival, it did confirm the finding of the previous study regarding its lack of association with other possible prognostic factors.
Is thrombocytosis a cancer?
Thrombocytosis appears to be a universal marker of adverse outcomes in cancer. Its association with worse oncologic outcomes has been reported in early and advanced breast cancer[6,7], ovarian cancer[8,9], genitourinary cancers[10,11] and several other types[12,13]. PATHOGENESIS OF THROMBO CYTOSIS IN CANCER.
Is platelet count a prognostic marker?
In gastrointestinal cancers of various locations and histologic types, thrombocytosis has been reported in general to be associated with adverse clinical outcomes. Platelet count measurement is well standardized and available in every clinical laboratory, making its use as a prognostic marker practical.
Is thrombocytosis a prognostic marker?
Thrombocytosis as a prognostic marker in gastrointestinal cancers
How to diagnose essential thrombocytosis?
Diagnosing essential thrombocytosis begins with a trip to your family doctor or when a routine blood test suggests a problem with the blood. Your doctor will ask you about any symptoms you have and do a physical exam to check if your spleen or liver is enlarged. Based on this information, your doctor will order tests to check for essential thrombocytosis or other health problems.
When does essential thrombocytosis develop?
Essential thrombocytosis usually develops around 60 years of age. It can also develop in younger people, especially women of child-bearing age.
What is the term for a neoplasm that develops when the bone marrow doesn't?
Essential thrombocytosis (ET) is also called essential thrombocythemia. It is a myeloproliferative neoplasm that develops when the bone marrow doesn’t work normally so it makes too many platelets. Essential thrombocytosis is a chronic disorder, which means that it develops slowly over time. It increases the risk of blood clots and bleeding.
What is CBC in medical terms?
complete blood count (CBC) to measure the number and quality of white blood cells, red blood cells and platelets
Does essential thrombocytosis cause bleeding?
Essential thrombocytosis may not cause any symptoms. Symptoms, when present, are often related to clot formation or bleeding problems.
How many people with thrombocytosis have no other symptoms?
And about one-third of patients with thrombocytosis and lung/colorectal cancer had no other symptoms that would indicate they had cancer.
Is thrombocytosis a predictor of cancer?
Researchers have found evidence to suggest that thrombocytosis is a strong predictor of cancer, particularly lung and colorectal cancer.
Does thrombocytosis cause cancer?
Patients with thrombocytosis had a higher incidence of cancer than individuals with normal platelet counts.
What is the blood cancer called?
Is one of a related group of blood cancers known as “myeloproliferative neoplasms” (MPNs) in which cells in the bone marrow that produce the blood cells develop and function abnormally. On average, individuals with ET have a normal life expectancy if they are properly monitored and treated.
Why do platelets form clots?
The platelets’ function is to start the process of forming a plug (clot) in response to blood vessel injury in order to prevent or minimize bleeding. When platelets are present in very high numbers they may not function normally and may cause a blockage in blood vessels, known as a "thrombus." Less often, a high number of platelets can also cause bleeding problems.
What is the term for an excess of platelets in the blood?
Another word for platelet is "thrombocyte.". The term "thrombocythemia" means an excess of platelets in the blood. The term "essential" indicates that the increase in platelets is an innate problem of the blood cell production in the bone marrow. "Secondary thrombocytosis" is the term for a condition that results in very high platelet counts in ...
What is a hematologist oncologist?
Hematologists oncologists are specialists who treat people who have ET or other types of blood cancer.
What is the function of platelets?
The platelets’ function is to start the process of forming a plug (clot) in response to blood vessel injury in order to prevent or minimize bleeding . When platelets are present in very high numbers they may not function normally and may cause a blockage in blood vessels, known as a "thrombus.".