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Platelet count measured prior to cancer development is a risk factor for future symptomatic venous thromboembolism: the Tromsø Study.
PLoS One 2014; 9(3):e92011Plos

Abstract

BACKGROUND

Elevated platelet count is associated with risk of venous thromboembolism in cancer patients initiating chemotherapy. It is not known whether this risk by platelet count is causal or merely reflects the malignant disease. We investigated whether pre-cancer platelet count alone or together with high leukocyte count was associated with risk of venous thromboembolism in subjects who did and did not develop cancer during follow-up in a population-based cohort study.

METHODS

Platelet count and other baseline characteristics were measured in 25160 initially cancer-free subjects who participated in the Tromsø Study in 1994-1995. Incident cancer and symptomatic venous thromboembolism events were registered up to December 31st, 2009. Multivariable Cox regression models were used to calculate hazard ratio for venous thromboembolism across categories of platelet count (<40th, 40-80th, and >80th percentile) with 95% confidence interval.

RESULTS

During follow-up, 2082 subjects were diagnosed with cancer. Platelet count was measured on average 8.3 years before the cancer diagnosis. There were 129 venous thromboembolism events in the cancer cohort (13.5 per 1000 person-years) and 377 in the non-cancer cohort (1.2 per 1000 person-years). In cancer patients, pre-cancer platelet count above the 80th percentile (≥295×10(9)/L) was associated with a 2-fold higher risk of venous thromboembolism (Hazard ratio: 1.98, 95% confidence interval 1.21-3.23) compared to platelet count below the 40th percentile (<235×10(9)/L). Concomitant high platelet and leukocyte counts showed a synergistic effect on the VTE risk. In cancer-free subjects, no association was found.

COMMENT

In conclusion, pre-cancer platelet count was associated with risk of symptomatic venous thromboembolism in cancer patients, but not in cancer-free subjects. Our findings suggest that platelet count and platelet-leukocyte interactions may play a role in the pathogenesis of cancer-related venous thromboembolism.

Authors+Show Affiliations

Hematological Research Group, Division of Internal Medicine, Department of Clinical Medicine, University of Tromsø, University Hospital of North Norway, Tromsø, Norway.Hematological Research Group, Division of Internal Medicine, Department of Clinical Medicine, University of Tromsø, University Hospital of North Norway, Tromsø, Norway.Hematological Research Group, Division of Internal Medicine, Department of Clinical Medicine, University of Tromsø, University Hospital of North Norway, Tromsø, Norway.Hematological Research Group, Division of Internal Medicine, Department of Clinical Medicine, University of Tromsø, University Hospital of North Norway, Tromsø, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24642868

Citation

Jensvoll, Hilde, et al. "Platelet Count Measured Prior to Cancer Development Is a Risk Factor for Future Symptomatic Venous Thromboembolism: the Tromsø Study." PloS One, vol. 9, no. 3, 2014, pp. e92011.
Jensvoll H, Blix K, Brækkan SK, et al. Platelet count measured prior to cancer development is a risk factor for future symptomatic venous thromboembolism: the Tromsø Study. PLoS ONE. 2014;9(3):e92011.
Jensvoll, H., Blix, K., Brækkan, S. K., & Hansen, J. B. (2014). Platelet count measured prior to cancer development is a risk factor for future symptomatic venous thromboembolism: the Tromsø Study. PloS One, 9(3), pp. e92011. doi:10.1371/journal.pone.0092011.
Jensvoll H, et al. Platelet Count Measured Prior to Cancer Development Is a Risk Factor for Future Symptomatic Venous Thromboembolism: the Tromsø Study. PLoS ONE. 2014;9(3):e92011. PubMed PMID: 24642868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Platelet count measured prior to cancer development is a risk factor for future symptomatic venous thromboembolism: the Tromsø Study. AU - Jensvoll,Hilde, AU - Blix,Kristine, AU - Brækkan,Sigrid K, AU - Hansen,John-Bjarne, Y1 - 2014/03/18/ PY - 2013/11/21/received PY - 2014/02/16/accepted PY - 2014/3/20/entrez PY - 2014/3/20/pubmed PY - 2014/12/20/medline SP - e92011 EP - e92011 JF - PloS one JO - PLoS ONE VL - 9 IS - 3 N2 - BACKGROUND: Elevated platelet count is associated with risk of venous thromboembolism in cancer patients initiating chemotherapy. It is not known whether this risk by platelet count is causal or merely reflects the malignant disease. We investigated whether pre-cancer platelet count alone or together with high leukocyte count was associated with risk of venous thromboembolism in subjects who did and did not develop cancer during follow-up in a population-based cohort study. METHODS: Platelet count and other baseline characteristics were measured in 25160 initially cancer-free subjects who participated in the Tromsø Study in 1994-1995. Incident cancer and symptomatic venous thromboembolism events were registered up to December 31st, 2009. Multivariable Cox regression models were used to calculate hazard ratio for venous thromboembolism across categories of platelet count (<40th, 40-80th, and >80th percentile) with 95% confidence interval. RESULTS: During follow-up, 2082 subjects were diagnosed with cancer. Platelet count was measured on average 8.3 years before the cancer diagnosis. There were 129 venous thromboembolism events in the cancer cohort (13.5 per 1000 person-years) and 377 in the non-cancer cohort (1.2 per 1000 person-years). In cancer patients, pre-cancer platelet count above the 80th percentile (≥295×10(9)/L) was associated with a 2-fold higher risk of venous thromboembolism (Hazard ratio: 1.98, 95% confidence interval 1.21-3.23) compared to platelet count below the 40th percentile (<235×10(9)/L). Concomitant high platelet and leukocyte counts showed a synergistic effect on the VTE risk. In cancer-free subjects, no association was found. COMMENT: In conclusion, pre-cancer platelet count was associated with risk of symptomatic venous thromboembolism in cancer patients, but not in cancer-free subjects. Our findings suggest that platelet count and platelet-leukocyte interactions may play a role in the pathogenesis of cancer-related venous thromboembolism. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24642868/Platelet_count_measured_prior_to_cancer_development_is_a_risk_factor_for_future_symptomatic_venous_thromboembolism:_the_Tromsø_Study_ L2 - http://dx.plos.org/10.1371/journal.pone.0092011 DB - PRIME DP - Unbound Medicine ER -