MPN/MDS OVERLAP SYNDROME ANTICIPATED BY A SEVERE BLEEDING DIATHESIS: HYPOTHESIS OF A PRE-EXISTING PLATELET DISORDER

Main Article Content

Paola Ranalli
Stefano Baldoni
Daniela Bruno
Mauro Di Ianni

Keywords

Myeloid Neoplasms; Germline mutations, Bleeding disorders

Abstract

We report the case of a patient with a conclusive diagnosis of “MDS/MPN” Overlap Syndrome preceded by platelet disorder and hemorrhagic phenotype. We want to induce a reflection about diagnosis of oncohematological disorders in patient with a documented personal history of bleeding and/or platelet disorder, considering all the possible differential diagnosis: 1) Bleeding as the epiphenomenon of a still undiagnosed Myeloid Neoplasm or 2) Myeloid Neoplasm with germline predisposition and pre-existing platelet disorder; 3) Inherited platelet disorder successively developing MPN/MDS Overlap Syndrome.


This case report underlines the importance of genetic testing in case of patient with documented platelet function disorder, including both mutations associated with inherited platelet disorders and germline mutations more strictly predisposing to Myeloid Neoplasms.

Downloads

Download data is not yet available.


Abstract 646
PDF Downloads 406
Html Downloads 41

References

1. Palma-Barqueros V, Revilla N, Sánchez A, Zamora Canovas A, Rodriguez-Alén A, Marin-Quìlez A, Gonzalez-Porras JR, Vicente V, Lozano ML, Bastida JM, Rivera J. Inherited Platelet Disorders: An Updated Overview. Int J Mol Sci. 2021;(9): 4521.
2. Kim B. Diagnostic workup of inherited platelet disorders. Blood Res. 2022; 30;57(S1):11-19.
3. Reinig EF, Rubinstein JD, Patil AT, Schussman AL, Horner VL, Kanagal-Shamanna R, Churpek JE, Matson DR. Leukemia. 2023; 37(8): 1589–99.
4. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016; 128(3):462-63.
5. Churpek JE, Lorenz R, Nedumgottil S, Onel K, Olopade OI, Sorrel A, Owen CJ, Bertuch AA, Godley LA. Proposal for the clinical detection and management of patients and their family members with familial myelodysplastic syndrome/acute leukemia predisposition syndromes. Leuk Lymphoma. 2013; 54(1):28-35.
6. Rolf N, Knoefler R, Bugert P, Gehrisch S, Siegert G, Kuhlisch E, Suttorp M. Clinical and laboratory phenotypes associated with the aspirin-like defect: a study in 17 unrelated families. Br J Haematol. 2009; 144(3):416-24.
7. Dragani A, Brancati F, Pascale S, Mattoscio D, Rocca B. Clinical and laboratory phenotype associated with the aspirin-like defect. Br J Haematol. 2010;148(4):661-63.
8. Patrono C, Rocca B, De Stefano V. Platelet activation and inhibition in polycythemia vera and essential thrombocythemia. Blood. 2013;121(10):1701-11.
9. Castaman G, Lattuada A, Ruggeri M, Tosetto A, Mannucci PM, Rodeghiero F. Platelet von Willebrand factor abnormalities in myeloproliferative syndromes. Am J Hematol. 1995; 49(4):289-93.
10. Lancellotti S, Dragani A, Ranalli P, Petrucci G, Basso M, Tartaglione R, Rocca B, De Cristofaro R. Qualitative and quantitative modifications of von Willebrand factor in patients with essential thrombocythemia and controlled platelet count. J Thromb Haemost. 2015 Jul;13(7):1226-37.
11. Gerrard JM, McNicol A. Platelet storage pool deficiency, leukemia, and myelodysplastic syndromes. Leuk Lymphoma. 1992;8(4-5):277-81.