Study of Platelet Indices in Patients of Chronic Myeloproliferative Disorders

Abstract

Background: Chronic myeloproliferative disorders (CMPDs), including Polycythemia Vera (PV), Essential Thrombocythemia (ET), and Primary Myelofibrosis (PMF), are clonal hematopoietic stem cell disorders characterized by dysregulated proliferation of myeloid lineages. Platelet abnormalities are central to their pathophysiology, predisposing patients to both thrombotic and hemorrhagic complications. Automated hematology analyzers provide platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR), and plateletcrit (PCT), that can serve as inexpensive biomarkers for diagnosis and prognostication.

Methods: A prospective observational study was conducted in the Department of Hematology/Pathology, Indira Gandhi Institute of Medical Sciences (I.G.I.M.S., from April 2020 to June 2022. A total of 160 patients diagnosed with CMPDs according to the World Health Organization (WHO) 2016 criteria were enrolled. Demographic, clinical, and laboratory data were collected. Platelet indices were recorded using a fully automated hematology analyzer. Data were analyzed using ANOVA, t-tests, chi-square, and correlation analyses, with p < 0.05 considered significant.

Results: ET was the most common CMPD (45%), followed by PV (33.8%) and PMF (21.2%). ET patients exhibited significantly higher platelet counts compared to PV and PMF (p < 0.001). PMF patients demonstrated the highest MPV, PDW, and P-LCR values, reflecting abnormal megakaryopoiesis. Thrombotic events occurred in 16.3% of patients and correlated with elevated MPV and PDW, while bleeding events (8.8%) were associated with increased PDW and reduced PCT.

Conclusion: Platelet indices differ significantly among CMPD subtypes and were associated with vascular complications. They represent cost-effective, readily available markers that may complement molecular and histological investigations for diagnosis, risk stratification, and disease monitoring in CMPDs.

Keywords: Chronic myeloproliferative disorders, platelet indices, thrombocytosis