Correlation of c-MPL Expression and Platelet Count in Thrombocytopenia Due to Chemotherapy Patients

Background: Thrombocytopenia is a commonly occurring side effect of chemotherapy and being the most common reason for clinicians in platelet transfusion. Many problems arise due to platelet transfusion, such as the availability, high cost, refractoriness and disease transmission. Therefore, it takes an alternative strategy to reduce the need for platelet transfusion. Thrombopoietin and its receptor c-MPL is a major regulator of platelet production that works by increasing proliferation and decreasing apoptosis of cells in the megakaryocytopoiesis system. Chemotherapy causes thrombocytopenia by myelosuppression process to megakaryocytopoiesis in which c-MPL expression is found. In thrombocytopenia due to chemotherapy there is an increase in thrombopoietin as a mechanism against the decrease of megakaryocytopoiesis, but unable to increase platelet production because of decreased expression of c-MPL due to suppression of megakaryocytopoiesis.

Aim: To know the correlation of c-MPL expression and platelet count in thrombocytopenia due to chemotherapy patients

Methods : An analytic observational study with a cross-sectional approach in October 2015-March 2016 in hematology and medical oncology clinic and inpatient of DR.M.Djamil Padang and private hospitals in Padang City. Subjects were chosen on a consecutive basis (n = 30).

Results : In this study obtained that thrombocytopenia due to chemotherapy was common in female sex and the most cases were rectal carcinoma. The mean expression of c-MPL was 11.18 ± 7.59 copies lower than the mean expression of c-MPL in healthy individuals was 797.18 ± 297.27 copies with p <0.05. Mean platelet count was 58,150 ± 39,474,81/mm³. There was a positive correlation between decreased expression of c-MPL and decreased platelet count in thrombocytopenia due to chemotherapy patients (r = 0.798; P <0.05).

Conclusion: There was a strong positive correlation between c-MPL expression and platelet count of thrombocytopenia due to chemotherapy patients, in other words a decrease in the level of c-MPL is in line with the decrease in platelet count.