INCREASED LEVELS OF THE SOLUBLE ADHESION MOLECULE E-SELECTIN IN PATIENTS WITH CHRONIC MYELOPROLIFERATIVE DISORDERS AND THROMBOEMBOLIC COMPLICATIONS

Patients with chronic myeloproliferative disorders (CMD) show a high f requency of thrombosis, For this reason we evaluated endothelial cell markers, soluble adhesion molecule E-selectin (sELAM), and thrombomodu lin (TM) in 25 patients with CMD. Among them nine presented thromboses in their past history. Data were compared with those obtained in a gr oup of healthy subjects and a group of patients with secondary thrombo cytosis. The mean plasma concentrations of sELAM were elevated in pati ents with CMD, as compared with healthy subjects (81.27 +/- 42.8 ng/ml vs. 41.75 +/- 13; P < 0.02), Similarly, the mean plasma concentration s of sTM were increased in CMD patients in comparison with the control group (102.0 +/- 73 ng/ml vs. 16.7 +/- 9.6; P < 0.01). More markedly elevated sELAM levels were observed in CMD patients with thrombosis th an in patients without thrombosis (113.16 +/- 29.5 ng/ml vs, 55.11 +/- 19.1 ng/ml; P < 0.001), while no significant difference was found bet ween CMD patients without thrombosis and secondary thrombocytosis (50. 72 +/- 10.8 ng/ml). Plasma thrombomodulin values in CMD patients with thrombosis (131 +/- 93.8 ng/ml) were higher than those without thrombo sis (65.77 +/- 43.9 ng/ml; P < 0.02). sTM values were also significant ly increased in patients with secondary thrombocytosis (P < 0.01). It is speculated that the plasma, sELAM levels may reflect endothelium ac tivation and that it is possibly useful in predicting the thrombotic r isk in myeloproliferative disorders. (C) 1998 Wiley-Liss, Inc.