Dr Amar Ranjan1, Ms Harshita Dubey1, Ms Sathya Veera Merla1
1All India Institute of Medical Sciences, New Delhi, India
Biography:
Dr. Amar Ranjan (MD, Pathology) is working as Professor, Lab Oncology, at the Cancer Institute, All India Institute of Medical Sciences, Delhi. He has been working on hematological malignancies. He has been involved in diagnostic work, research, and the teaching of postgraduate students.
Abstract:
Introduction
Thrombopoietin (TPO) has a significant prognostic value in cancer.
Material & Method
We studied 45 cases (30 male and 15 female) of gastrointestinal cancer, which underwent surgery. Two groups were considered: 1st, cases without prior radiotherapy (RT), 34, and 2nd, cases with prior RT, 11. TPO and platelet count were measured on day 1 preoperatively and day 3 after surgery.
Result
TPO value: preoperatively; Group 1: 174.8 ± 98.2 pg/ml; & Group 2: 220.3 ± 120.7 pg/ml, although not statistically significant (p-value 0.2). Day 3 Postoperatively: Group 1: 287.2±177.3 pg/ml & Group 2: 472.6 ± 265.2 pg/ml. This difference was statistically significant (p-value 0.01). The corresponding platelet counts preoperatively were 0.86 ± 0.89 lakh/cm and 1.9±0.62 lakh/cm (p-value 0.72). The corresponding platelet counts post-operatively were 1.52 +/- 0.53 lakh/ cmm and 1.06 +/- 0.51 lakh/cmm (p-value 0.02). Similar to the TPO value, the postoperative difference in platelet count was also statistically significant.
Discussion
After surgery, a sharp rise in TPO level among the patients who were already treated with RT is an indicative good therapeutic response. Votsadakis IA 2014 showed thrombocytosis as an adverse prognostic factor in gastrointestinal cancers. Wang et al. (2015) studied that introduction of rHuTPO resulted in proliferation of hemopoietic stem cells in mice with improved survival after radiation exposure (2).
Conclusion
A higher TPO level after surgery or radiotherapy is an indicator of a better response. Thrombocytosis prior to therapy indicates poor prognosis.
Keywords: thrombopoietin, radiotherapy, sepsis