scholarly journals Enoxaparin-induced reactive thrombocytosis: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tao Xiang ◽  
Ming Cheng
Keyword(s):  
Molecular Weight ◽  
Platelet Count ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Hip Replacement ◽  
Low Molecular Weight ◽  
Blood Cell Count ◽  
Reactive Thrombocytosis

Abstract Background Enoxaparin is an anticoagulant that falls in the class of medications called low molecular weight heparins (LMWHs), and is used to prevent or treat patients with deep vein thrombosis (DVT) and pulmonary embolism. Enoxaparin is the most widely used LMWH for DVT prophylaxis following knee or hip replacement surgery. Common side effects of enoxaparin include bleeding, petechiae at the injection site, and thrombocytopenia. However, reactive thrombocytosis is a rarely reported adverse reaction. We managed a patient who developed enoxaparin-associated thrombocytosis, which was completely resolved after treatment cessation. Case presentation A 78-year-old female was hospitalized for post-hip replacement rehabilitation. Low molecular weight heparin 40 mg/day was administered subcutaneously to prevent deep venous thrombosis (DVT). At admission, her platelet count was normal (228 × 109/L) and her white blood cell count was slightly elevated (12.91 × 109/L). Seven days after admission, the patient developed thrombocytosis, which peaked on the 14th day (836 × 109/L), while her white blood cell count had returned to normal (8.86 × 109/L). Her therapeutic regimen was reviewed, and enoxaparin was identified as a potentially reversible cause of reactive thrombocytosis. Switching from enoxaparin to rivaroxaban lead to a gradual decrease in the patient’s platelet count, which eventually returned to normal levels 16 days after enoxaparin was discontinued. No complications secondary to thrombocytosis was observed, and no conclusion was reached on the use of small doses of aspirin for antithrombotic therapy under these circumstances. Conclusion Enoxaparin-induced reactive thrombocytosis should be suspected in patients with thrombocytosis following enoxaparin administration as an anticoagulant to prevent certain complications.

Diagnostic value of post-operative platelet-to-white blood cell ratio after splenectomy in patients with advanced ovarian cancer

2019 ◽  
Vol 29 (8) ◽  
pp. 1292-1297 ◽  
Author(s):  
Konstantinos Lathouras ◽  
Georgios Panagakis ◽  
Sarah Joanne Bowden ◽  
Konstantinos Saliaris ◽  
Srdjan Saso ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Platelet Count ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Predictive Value ◽  
Blood Cell Count ◽  
Cell Ratio ◽  
Grade Iii

IntroductionSplenectomy-induced thrombocytosis and leukocytosis may obscure the early diagnosis of post-operative infection or sepsis. In trauma patients after splenectomy, a platelet-to-white blood cell ratio of <20 has been shown to reliably differentiate post-operative sepsis from transient physiological responses.ObjectiveTo determine whether the platelet-to-white blood cell ratio can be applied to differentiate between reactive post-operative changes and latent infection.MethodsAll consecutive patients with ovarian cancer who underwent splenectomy between January 2013 and October 2018 in two large European gynecological cancer centers were retrospectively evaluated. Main outcome measures were white blood cell count, platelet count, and platelet-to-white blood cell ratio on post-operative days 1, 5, and 7. These were correlated with surgical outcome and morbidity according to the Clavien-Dindo classification. A binomial logistic regression was applied to assess the predictive value of day 5 platelet-to-white blood cell ratio, white blood cell count, and platelet count for predicting grade III post-operative sepsis.ResultsNinety-five patients with ovarian cancer (mean age 54 years, range 18–75) were identified. Seventeen patients (17.9%) developed a grade III post-operative sepsis. In all post-operative patients, mean white blood cell count on day 5 decreased (from 15.4×103/μL to 11.4×103/μL), while the mean platelet count rose (from 260.7×103/μL to 385.3×103/μL). A high platelet count (>313×103/μL) failed to show any predictive value (OR=0.94; 95% CI 0.30 to 3.0; p=0.921). A low platelet-to-white blood cell ratio (<26) (OR=3.49; 95% CI 1.18 to 10.32; p=0.0241) and high white blood cell count (>14.5×103/μL) on day 5 (OR=11.0; 95% CI 3.3 to 36.2; p<0.001) were significant for predicting sepsis. Despite a significant OR, the sensitivity and specificity were low; day 5 platelet-to-white blood cell ratio at a cut-off point of 26 achieved a sensitivity of 72% and specificity of 53% (area under the curve 0.637, 95% CI 0.480 to 0.796) in predicting grade III post-operative sepsis.ConclusionsPlatelet-to-white blood cell ratio after cytoreductive surgery for ovarian cancer with splenectomy does not appear to have a strong predictive value in differentiating between sepsis and reactive splenectomy-induced changes. Leukocytosis, in combination with clinical assessment, may remain the most useful tool for prediction of sepsis after cytoreductive surgery with splenectomy.

Hydroxyurea in essential thrombocythemia: rate and clinical relevance of responses by European LeukemiaNet criteria

Blood ◽  
2010 ◽  
Vol 116 (7) ◽  
pp. 1051-1055 ◽  
Author(s):  
Alessandra Carobbio ◽  
Guido Finazzi ◽  
Elisabetta Antonioli ◽  
Alessandro M. Vannucchi ◽  
Giovanni Barosi ◽  
...  
Keyword(s):  
Platelet Count ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Essential Thrombocythemia ◽  
Complete Response ◽  
Blood Cell Count ◽  
Predictors Of Response ◽  
Definition Of

Abstract A definition of response by cytoreductive therapy in essential thrombocythemia was recently provided by the European LeukemiaNet (ELN). Complete, partial, or no clinicohematologic responses were defined on the bases of platelet count, disease-related symptoms, spleen size, and white blood cell count. To provide estimates and clinical correlation of responses according to these criteria, we retrospectively examined 416 essential thrombocythemia patients treated with hydroxyurea for at least 12 months. Complete response, partial response, and no response were 25%, 58%, and 17%, respectively. Age more than 60 years and JAK2V617F mutation were significant predictors of response. After a median follow-up of 3.9 years, we registered 23 deaths, 16 hematologic transformations, and 27 thrombotic events (rate, 1.66% patients/year). Age, previous thrombosis, leukocytosis (white blood cell count > 10 × 109/L), but not ELN responses, were independently associated with higher risk of thrombosis. The actuarial probability of thrombosis was significantly influenced by leukocytosis (P = .017) and not by platelet count, indicating that platelet number does not seem of prime relevance in the definition of ELN response.

scholarly journals Response criteria for essential thrombocythemia and polycythemia vera: result of a European LeukemiaNet consensus conference

Blood ◽  
2009 ◽  
Vol 113 (20) ◽  
pp. 4829-4833 ◽  
Author(s):  
Giovanni Barosi ◽  
Gunnar Birgegard ◽  
Guido Finazzi ◽  
Martin Griesshammer ◽  
Claire Harrison ◽  
...  
Keyword(s):  
Platelet Count ◽  
Blood Cell ◽  
Cell Count ◽  
Polycythemia Vera ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Essential Thrombocythemia ◽  
Mutant Allele ◽  
Blood Cell Count ◽  
Histologic Response

European experts were convened to develop a definition of response to treatment in polycythemia vera (PV) and essential thrombocythemia (ET). Clinicohematologic (CH), molecular, and histologic response categories were selected. In ET, CH complete response (CR) was: platelet count less than or equal to 400 × 109/L, no disease-related symptoms, normal spleen size, and white blood cell count less than or equal to 10 × 109/L. Platelet count less than or equal to 600 × 109/L or a decrease greater than 50% was partial response (PR). In PV, CH-CR was: hematocrit less than 45% without phlebotomy, platelet count less than or equal to 400 × 109/L, white blood cell count less than or equal to 10 × 109/L, and no disease-related symptoms. A hematocrit less than 45% without phlebotomy or response in 3 or more of the other criteria was defined as PR. In both ET and in PV, molecular CR was a reduction of any molecular abnormality to undetectable levels. Molecular PR was defined as a reduction more than or equal to 50% in patients with less than 50% mutant allele burden, or a reduction more than or equal to 25% in patients with more than 50% mutant allele burden. Bone marrow histologic response in ET was judged on megakaryocyte hyperplasia while on cellularity and reticulin fibrosis in PV. The combined use of these response definitions should help standardize the design and reporting of clinical studies.

Quantitative trait loci for baseline white blood cell count, platelet count, and mean platelet volume

2005 ◽  
Vol 16 (10) ◽  
pp. 749-763 ◽  
Author(s):  
Luanne L. Peters ◽  
Weidong Zhang ◽  
Amy J. Lambert ◽  
Carlo Brugnara ◽  
Gary A. Churchill ◽  
...  
Keyword(s):  
Platelet Count ◽  
Quantitative Trait Loci ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Quantitative Trait ◽  
Mean Platelet Volume ◽  
Blood Cell Count ◽  
Platelet Volume

An open-label phase Ib study to determine safety and preliminary efficacy of oral Lucitanib (AL3810) in patients with locally advanced or metastatic gastric, hepatocellular, nasopharyngeal carcinoma, malignant biliary, and thymic tumors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15502-e15502
Author(s):  
Hongming Pan ◽  
Shukui Qin ◽  
Li Zhang ◽  
Jin Li ◽  
Jianming Xu ◽  
...  
Keyword(s):  
Platelet Count ◽  
Nasopharyngeal Carcinoma ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Kinase Inhibitor ◽  
Locally Advanced ◽  
Blood Cell Count ◽  
Thymic Tumors

e15502 Background: Angiogenesis is an essential prerequisite for tumor growth, invasion and metastasis. Targeting tumor angiogenesis has become a common therapeutic target in clinical work. Lucitanib, an oral tyrosine kinase inhibitor, precisely targets FGFR/VEGFR/PDFGR. In this study, we evaluated the safety profile and preliminary anti-tumor effects of lucitanib in patients with locally advanced or metastatic gastric (GC), hepatocellular (HCC), nasopharyngeal carcinoma (NPC), malignant biliary (MBT) and thymic tumors (TT). Methods: Patients (Pts) with locally advanced or metastatic GC, HCC, NPC, BTC and TT, standard therapy failed, ECOG status ≤1, were enrolled. Total 44 subjects (6 GC, 4 HCC, 10 BTC, 4 TT, 20 NPC) were recruited, then randomized into two groups with lucitanib 10 mg QD given continuously (CON) or intermittently (INT) lucitanib 10 mg QD three weeks on and one week off. Results: 22 pts were included in CON and INT group respectively. The most common drug-related treatment emergent adverse events (TEAEs) for CON (AE≥10%, Grade≥3 ): proteinuria (19 [86.4%], 4 [18.2%]), hypertension (18 [81.8%], 7 [31.8%]), haematuria (3 [13.6%], 0), aspartate aminotransferase increased (8 [36.4%], 1 [4.5%]), hypothyroidism (7 [31.8%], 0), blood creatinine increased (5 [22.7%], 0), platelet count decreased (5 [22.7%], 1[4.5%]), white blood cell count decreased (3 [13.6%], 0), weight decreased (4 [18.2%], 0), diarrhea (4 [18.2%], 0) and rash(6 [27.3%], 0). For INT: proteinuria (8 [36.4%], 1[4.5%]), hypertension (9 [40.9%], 4 [18.2%]), hypothyroidism (6 [27.3%], 0), platelet count decreased (3 [13.6%], 0), white blood cell count decreased (4 [18.2%], 0). Treatment discontinuation due to drug-related TEAEs were 3 pts (13.6%) and 1 pt (4.5%) in CON and INT respectively. Preliminary efficacy for CON: ORR: 13.6%, DCR: 72.7%, median PFS: 3.8 months; for INT: ORR: 4.5%, DCR: 40.9%, median PFS: 1.9 months. Conclusions: Although CON exhibited higher incidence, drug-related TEAEs at both groups were expected and manageable. Lucitanib exhibited better efficacy profile when administrated 10mg QD continuously. Further safety and efficacy of lucitanib is being evaluated in phase II/III studies. Clinical trial information: 03260179.

scholarly journals Survival After Endovascular Aneurysm Sealing Compared With Endovascular Aneurysm Repair

2021 ◽  
pp. 152660282110250
Author(s):  
Aleksandra C. Zoethout ◽  
Arshad Sheriff ◽  
Clark J. Zeebregts ◽  
Andrew Hill ◽  
Michel M. P.J. Reijnen ◽  
...  
Keyword(s):  
Platelet Count ◽  
Inflammatory Response ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Endovascular Aneurysm Repair ◽  
Blood Cell Count ◽  
Aneurysm Repair

Introduction Endovascular aneurysm sealing (EVAS) is a sac-filling device with a blunted systemic inflammatory response compared to conventional endovascular aneurysm repair (EVAR), with a suggested impact on all-cause mortality. This study compares mortality after both EVAS and EVAR. Materials and Methods This is a retrospective observational study including data from 2 centres, with ethical approval. Elective procedures on asymptomatic infrarenal aneurysms performed between January 2011 until April 2018 were enrolled. Laboratory values (serum creatinine, haemoglobin, white blood cell count, platelet count) were measured pre- and postoperatively and at 1 and 2 years, respectively. Mortality and cause of death were recorded during follow-up. Results A total of 564 patients were included (225 EVAS, 369 EVAR), after propensity score matching there were 207 patients in both groups. Baseline characteristics were similar, except for larger neck angulation and more pulmonary disease in the EVAR group. The median follow-up time was 49 (EVAS) and 44 (EVAR) months. No significant differences regarding creatinine and haemoglobin were observed. Preoperative white blood cell count was higher in the EVAR group (p=0.011), without significant differences during follow-up. Median platelet count was lower in the EVAR group preoperatively (p=0.001), but was significantly higher at 1 year follow-up (p=0.003). There were 43 deaths within the EVAS group (20.8%) and 52 within the EVAR group (25.1%) (p=0.293). Of these, 4 were aneurysm related (EVAS n=3, EVAR n=1; p=0.222) and 14 cardiovascular (EVAS n=6, EVAR n=8, p=0.845). For the EVAS cohort, survival was 95.5% at 1 year and 74.9% at 5 years. For the EVAR cohort, this was 93.3% at 1 year and 75.5% at 5 years. No significant differences were observed in causes of death. Conclusion This study showed comparable survival rates through 5 years between EVAS and EVAR with a tendency toward higher inflammatory response in the EVAR patients through the first 2 years.

scholarly journals White Blood Cells and Severe COVID-19: A Mendelian Randomization Study

2021 ◽  
Vol 11 (3) ◽  
pp. 195
Author(s):  
Yitang Sun ◽  
Jingqi Zhou ◽  
Kaixiong Ye
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Blood Cells ◽  
Mendelian Randomization ◽  
Association Studies ◽  
White Blood Cells ◽  
Genome Wide Association Studies ◽  
Blood Cell Count

Increasing evidence shows that white blood cells are associated with the risk of coronavirus disease 2019 (COVID-19), but the direction and causality of this association are not clear. To evaluate the causal associations between various white blood cell traits and the COVID-19 susceptibility and severity, we conducted two-sample bidirectional Mendelian Randomization (MR) analyses with summary statistics from the largest and most recent genome-wide association studies. Our MR results indicated causal protective effects of higher basophil count, basophil percentage of white blood cells, and myeloid white blood cell count on severe COVID-19, with odds ratios (OR) per standard deviation increment of 0.75 (95% CI: 0.60–0.95), 0.70 (95% CI: 0.54–0.92), and 0.85 (95% CI: 0.73–0.98), respectively. Neither COVID-19 severity nor susceptibility was associated with white blood cell traits in our reverse MR results. Genetically predicted high basophil count, basophil percentage of white blood cells, and myeloid white blood cell count are associated with a lower risk of developing severe COVID-19. Individuals with a lower genetic capacity for basophils are likely at risk, while enhancing the production of basophils may be an effective therapeutic strategy.

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