Hematology profile (platelets, mean platelet volume, platelet distribution width, white blood cells, hemoglobin) to differentiate essential and reactive thrombocytosis
Keywords:
Essential thrombocytosis, Reactive thrombocytosis, Hematology profile, mean platelet volume (MPV), platelet distribution width (PDW), PlateletsAbstract
Background: An elevated platelet count, either primary (such as ET) or secondary (such as RT), is the hallmark of thrombocytosis. These two conditions have different clinical implications and management approaches, but are often difficult to distinguish clinically. Routine hematological tests, including platelet count, MPV, PDW, leukocyte count, and hemoglobin, have the potential to serve as easily accessible initial parameters to help differentiate between the two conditions. The purpose of this study is to assess how routine hematological indicators can be used to distinguish between ET and RT.
Materials and Methods: A retrospective cross-sectional analytical observational study was conducted at Makassar's Dr. Wahidin Sudirohusodo General Hospital between November 2024 and January 2025. The study subjects were patients with platelet counts ≥450,000/mm³. The determination of ET and RT was based on the evaluation of thrombocytosis persistence, peripheral blood smear examination, and bone marrow aspiration.
Results: A total of 90 thrombocytosis patients were analyzed, including 37 patients ET and 53 patients RT. The mean age in ET was 41.1±11.1 years and in RT was 45.2±10.2 years. The mean WBC count was higher in ET than in RT (19.06±14.8 vs. 15.1±6.5 ×10³/µL; p=0.265). ET had significantly higher platelet counts (1,418.3±735.9 vs. 605±126.5 ×10³/µL; p<0.001) and Hb levels (13.06±2.3 vs. 8.7±1.8 g/dL; p<0.001). MPV values were slightly higher in ET (8.9±1.0 vs. 8.79±0.8 fL; p<0.001), while PDW did not differ significantly between the two groups (11.0±3.4 vs. 8.8±1.6 fL; p=0.311).
Conclusion: Hemoglobin, MPV, and platelet count were all higher in essential thrombocytosis than in reactive thrombocytosis.
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