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Blood, 15 July 2002, Vol. 100, No. 2, pp. 714-717
BRIEF REPORT
The expression pattern of c-mpl in megakaryocytes
correlates with thrombotic risk in essential thrombocythemia
Luciana Teofili,
Francesco Pierconti,
Annalaura Di
Febo,
Nicola Maggiano,
Nicola Vianelli,
Stefano Ascani,
Elena Rossi,
Stefano Pileri,
Giuseppe Leone,
Luigi Maria Larocca, and
Valerio De
Stefano
From the Departments of Hematology and Pathology,
Catholic University, Rome, Italy; and the Institute of Hematology
Seragnoli, University of Bologna, Bologna, Italy.
Using immunohistochemistry, we investigated the expression of
c-mpl in bone marrow megakaryocytes of 88 patients with
essential thrombocythemia (ET), 6 patients with secondary
thrombocytosis (ST), and 20 patients with lymphoma (controls).
Considering both the pattern of expression and the staining intensity,
we identified a uniform and a heterogeneous pattern of c-mpl
expression. The uniform pattern was found in all the controls,
all the patients with ST, and 28 of the patients with ET, with a strong
staining intensity observed in most megakaryocytes (> 80%). In
contrast, c-mpl expression was heterogeneous in 60 patients
with ET, 18 of whom (30%) presented with thrombosis at diagnosis, a
significant difference from patients with a uniform
c-mpl pattern (2 of 28; 7%; P = .026).
In particular, the overrepresentation of thrombotic complications in
patients with a heterogeneous c-mpl expression pattern was
found mainly among patients with a significant percentage (10% to
40%) of weakly stained or c-mpl-negative megakaryocytes (heterogeneous-weak pattern; 13 of 30; 43%;
P = .002). Accordingly, this pattern was
associated with a 6.1-fold increased risk of thrombosis compared with
that of patients with a uniform c-mpl pattern. In
conclusion, the presence of a heterogeneous pattern of
c-mpl distribution in bone marrow megakaryocytes could be a useful diagnostic criterion in the differential diagnosis of
thrombocytosis. Furthermore, detection of a significant percentage of
weakly stained or c-mpl-negative megakaryocytes can
identify patients with a higher risk of thrombosis.
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