Change and clinical significance of peripheral blood endothelial progenitor cells in patients with myeloproliferative neoplasms
Objective To observe the change of peripheral blood endothelial progenitor cells(EPCs)in patients with myeloproliferative neoplasms(MPNs),and to investigate its relationships with blood cell count,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)and JAK2V617F mutation.Methods From June 2013 to December 2020,105 patients with MPNs(MPNs group),45 patients with non-MPNs hematologic malignancies(malignancy group)and 52 patients with benign hematologic diseases(control group)were initially diagnosed and treated in Beijing Anzhen Hospital.In MPNs group,there were 38 patients with polycythemia vera(PV),61 patients with essential thrombocythemia(ET)and 6 patients with primary myelofibrosis(PMF).The hemoglobin(Hb),white blood cell count(WBC),red blood cell count(RBC),platelet(PLT),hematocrit(Hct),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hs-CRP,proportion of＞1 cardiovascular risk factors(CVRFs),and EPCs number on admission were compared among three groups.The differences in EPCs number were analyzed in MPN patients with different clinical characteristics.Spearman correlation method was used to analyze the correlations of EPCs number with blood cell count,IL-6,TNF-αand hs-CRP in MPNs patients.Results(1)The Hb,WBC,RBC,PLT and Hct were higher in MPNs group[152(57,235)g/L,9.14(2.91,30.56)×109/L,5.05(1.68,9.99)× 1012/L,557(82,2 126)× 109/L,(45.39± 10.60)％]than those in malignancy group[99(40,165)g/L,6.55(1.50,146.03)× 109/L,3.12(1.24,5.13)×1012/L,137(4,1 305)×109/L,(29.96±13.17)％]and control group[137(62,237)g/L,5.60(2.27,15.12)× 109/L,4.62(1.62,6.84)×1012/L,208(32,658)× 109/L,(39.31±16.68)％](P＜0.05).The Hct and PLT were lower in malignancy group than those in control group(P＜0.05).The proportion of＞1 CVRFs was higher in MPNs group(64.76％)and malignancy group(62.22％)than that in control group(38.46％)(P＜0.05).(2)The peripheral blood EPCs number was greater in MPNs group[306(0,4 303)cells/mL]and malignancy group[193(0,2 920)cells/mL]than that in control group[87(0,2 616)cells/mL](U=-4.251,P＜0.001;U=-2.031,P=0.042),and showed no significant difference between MPNs group and malignancy group(U=-1.267,P=0.205).(3)The numbers of peripheral blood EPCs were greater in males,＞60-year old patients with J AK2V617F mutation positive,＞1 CVRFs and PV patients[435(0,4 303),363(0,4 303),375(0,4 303),404(0,2 622)cells/mL]than those in females,＞60-year old patients with JAK2V617F mutation negative,1 CVRF,PMF patients and ET patients[227(0,3 300),248(0,2 639),165(0,3 330),328(0,2 478),240(0,4 303)cells/mL](P＜0.05),and showed no significant differences between＞60-year old patients with JAK2V617F mutation positive and≤60-year old patients with JAK2V617F mutation negative(P＞0.05).(4)The IL-6 level in MPNs patients was[16.50(3.60,36.70)ng/L]and TNF-a was[12.45(0.40,199.00)ng/L].The EPCs number in MPN patients was not correlated with PLT(r=0.094,P=0.342)and hs-CRP(r=0.011,P=0.914),but was positively correlated with WBC(r=0.196,P=0.046),RBC(r=0.198,P=0.043),Hb(r=0.205,P=0.036),Hct(r=0.215,P=0.028),IL-6(r=0.322,P=0.004)and TNF-α(r=0.252,P=0.036).Conclusions The peripheral blood EPC increases in number in patients with hematologic malignancies,especially in patients with MPN,and it increases significantly in males,PV patients,＞60-year old patients with JAK2V617F mutation,and patients with＞1 CVRF.The increase of EPCs number in peripheral blood may be correlated with clonal proliferation and inflammation of stem cells.
myeloproliferative neoplasmsendothelial progenitor cellsblood cell countinterleukin-6tumor necrosis factor-αhigh-sensitivity C-reactive protein
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