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.: Home > International Journal of Medical Sciences > 2008 > Volume 5 Number 2 > Jan Palmblad1, Magnus Bjِrkholm2, Jack Kutti3, Gerd Lنrfars4, Eva Lِfvenberg1, Berit Markevنrn5, Mats Merup1, Nils Mauritzson6, Jan Westin6, Jan Samuelsson4 and Gunnar Birgegهrd7

TPO, but not soluble-IL-6 receptor, levels increase after anagrelide treatment of thrombocythemia in chronic myeloproliferative disorders

Jan Palmblad1, Magnus Bjِrkholm2, Jack Kutti3, Gerd Lنrfars4, Eva Lِfvenberg1, Berit Markevنrn5, Mats Merup1, Nils Mauritzson6, Jan Westin6, Jan Samuelsson4 and Gunnar Birgegهrd7
1. Hematology Center, Karolinska University Hospital Huddinge, Stockholm 2. Hematology Center, Karolinska University Hospital Solna, Stockholm 3. Dept of Hematology, Sahlgrenska University Hospital, Gِteborg 4. Dept of Medicine, Stockholm South Hospital, Stockholm 5. Dept of Medicine, University Hospital, Umeه 6. Dept of Hematology, University Hospital, Lund, Sweden 7. Dept of Medicine, University Hospital, Uppsala, for the Swedish MPD Study Group.
Abstract :

Anagrelide is often used in the treatment of thrombocythemia in myeloproliferative disease (MPD), but information concerning effects of treatment on cytokines involved in regulation of blood platelet levels is limited. Here, we investigated serum levels of thrombopoietin (TPO) and soluble IL-6 receptor (sIL-6R) in relation to response to treatment with and plasma concentrations of anagrelide. Samples from 45 patients with thrombocythemia due to MPD (ET=31, PV=14), being treated with anagrelide for 6 months, were analyzed for TPO, sIL-6R and anagrelide levels. The mean baseline platelet count was 983x109/L. A reduction of platelets to <600 in asymptomatic or <400 x 109/L in symptomatic patients was defined as a complete remission (CR), a reduction with >50% of baseline as partial remission, and <50% reduction as failure. At 6 months, 35 patients were in CR, 1 had a partial remission and 9 were treatment failures. For all patients, there was an increase in TPO of 44% from baseline; this change was more pronounced for patients with partial remission and failure. sIL-6R levels did not change significantly. There was no correlation between levels of anagrelide and cytokine levels at 6 months, and changes of cytokine levels did not relate to changes of platelet counts. Thus, a pronounced increase of TPO levels after 6 months of anagrelide treatment indicated that this treatment affected a major regulatory mechanism for megakaryocyte and platelet formation in MPD.

Keywords :
thrombocythemia, anagrelide, thrombopoietin, IL-6, soluble receptors

Date Deposited : 28 Jul 2011 10:52

Last Modified : 28 Jul 2011 10:52

Official URL: http://www.medsci.org/archive

Volume 5, Number 2, - 2008 , ISSN 1449-1907

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