ISSN: 2148-4902 | E-ISSN: 2536-4553
Morphologic Evaluation of Megakaryocytes in Immune Thrombocytopenia Patients Older than 80 Years [North Clin Istanb]
North Clin Istanb. Ahead of Print: NCI-57124 | DOI: 10.14744/nci.2022.57124

Morphologic Evaluation of Megakaryocytes in Immune Thrombocytopenia Patients Older than 80 Years

Ufuk Demirci, Elif Umit, Mehmet Baysal, Ahmet Muzaffer Demir
Trakya University, Department of Hematology, Edirne, Türkiye

Objective: In immune thrombocytopenia (ITP), which is a common acquired bleeding disorder, cytotoxic T cell mediated cellular immune response against both circulating platelets and bone marrow megakaryocytes are the most important mechanisms in the pathogenesis.
Method: In our study we evaluated the features of 33 patients with ITP, over 80 years of age.
Results: The median age of the patients was 90, 15 patients were female (45,4%). The mean platelet count of the patients was 39 x109/L and the mean of mean platelet volume was 10,33fL. Twelve patients had a target thrombocyte count greater than 30x109/L, while 20 patients had a target platelet count of 75x109/L or greater with an absolute indication of antiaggregation. In the environmental spread, 18 dysplasia findings were observed.
Conclusion: Morphologic observations suggesting dysplasia including micromegakaryocytes and a non-dysplastic but dysmegakaryopoietic finding, multiple segmented nucleus may be related with the degree of thrombocytopenia and response to treatment. Likewise, nondysplastic features including immature forms, emperipolesis, bare nucleus, hypolobulation and hypersegmented nucleus were related with the degree of thrombocytopenia.

Keywords: Immune thrombocytopenia, Megakaryocyte, Dysplasia, Dysmegakaryopoiesis

Morphologic Evaluation of Megakaryocytes in Immune Thrombocytopenia Patients Older than 80 Years

Ufuk Demirci, Elif Umit, Mehmet Baysal, Ahmet Muzaffer Demir
Trakya Üniversitesi, Hematoloji Anabilim Dalı, Edirne

Giriş: Yaygın bir edinsel kanama bozukluğu olan immün trombositopenide (İTP), hem dolaşımdaki trombositlere hem de kemik iliğinde megakaryositlere yönelik oluşan sitotoksik T hücre aracılı hücresel immün yanıt patogenezdeki en önemli mekanizmalardandır.
Yöntem: Çalışmamızda 80 yaş üstü 33 İTP'li hastanın özelliklerini değerlendirdik.
Sonuç: Hastaların ortanca yaşı 90, 15'i kadındı (%45,4). Hastaların ortalama trombosit sayısı 39 x109/L, ortalama trombosit hacmi ortalama 10,33fL idi. On iki hastada hedef trombosit sayısı 30x109/L'den fazlayken, 20 hastada mutlak antiagregasyon endikasyonu ile 75x109/L veya daha yüksek hedef trombosit sayısı vardı. Periferik yaymada 18 hastada displazi bulgusu gözlendi.
Sonuç: Morfolojik olarak displaziyi düşündüren ancak displazi bulgusu olmayan çok sayıda çekirdek içeren Megakaryositler ve dismegakaryopoietik bir bulgu olan mikromegakaryosit bulguları trombositopeninin derecesi ve tedaviye yanıt ile ilişkili olabilir. Benzer şekilde immatür formlar, emperipolez, çıplak nükleus, hipolobulasyon ve hipersegmente nükleus gibi displastik olmayan özellikler de trombositopeni derecesi ile olduğu görüldü. (NCI-2022-5-17/R1)

Anahtar Kelimeler: İmmun Trombositopeni, Megakaryosit, Displazi, Dismegakaryopoez



Corresponding Author: Ufuk Demirci
Manuscript Language: English
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