Increased mean platelet volume (MPV) is an independent predictor of inferior survival in patients with primary and secondary myelofibrosis.

Neoplastic megakaryopoiesis is a dominant feature of Philadelphia-chromosome-negative myeloproliferative neoplasms (Ph- MPNs), and elevated mean-platelet-volume (MPV) is a common finding in these diseases. The clinical and prognostic significances of MPV in patients with primary (PMF) and secondary myelofibrosis (SMF) have not been reported. We retrospectively analyzed 87 patients with myelofibrosis (66 with PMF, 21 with SMF) treated at our institution. MPV was recorded in addition to other hematological and clinical parameters. MPV was elevated in both PMF and SMF patients in comparison to controls, whereas there was no statistically significant difference between PMF and SMF. Elevated MPV was associated with lower platelets (P = 0.016), higher white blood cells (P = 0.015), higher percentage of circulatory blasts (P = 0.009), higher lactate dehydrogenase (P = 0.011), larger spleen size (P = 0.014) and higher Dynamic International Prognostic score category (P = 0.027), while there was no statistically significant association with driver mutations or degree of bone marrow fibrosis. Higher MPV was univariately associated with inferior overall survival in the whole cohort (HR = 3.82, P = 0.006), PMF (HR = 4.35, P = 0.007) and SMF patients (HR = 7.22, P = 0.034). These associations remained significant in multivariate analyses adjusted for DIPSS. Higher MPV is associated with more aggressive disease features and exhibits powerful independent prognostic properties in both PMF and SMF settings.

Comparison of diagnostic value of indirect immunofluorescence assay and desmoglein ELISA in the diagnosis of pemphigus.

Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are autoimmune blistering diseases characterized by intraepidermal separation as the result of autoantibodies directed to desmoglein 1 and desmoglein 3, adhesion molecules that have a pathogenic role in blister formation. Both PV and PF are diagnosed according to clinical picture, histopathologic, immunopathologic and molecular biologic features. In the present study, the value of indirect immunofluorescence (IIF) and enzyme linked immunosorbent assay (ELISA) for desmoglein 1 (Dsg 1) and desmoglein 3 (Dsg 3) at baseline visit was compared. The study was performed as a retrospective study that included 22 patients, 19 of them with PV and three with PF. Patient sera were tested with IIF and Dsg 1 and Dsg 3 ELISA. In the group of 19 PV patients, 12 patients had positive IIF, Dsg 3 and Dsg 1 ELISA; two had positive IIF and positive anti Dsg 3 but negative anti Dsg 1; three had negative IIF but positive both Dsg 1 and Dsg 3 antibodies; and two had negative IIF and Dsg 1 but positive Dsg 3 antibodies. In the group of PF patients, all three patients had positive IIF, positive Dsg 1 ELISA and negative Dsg 3 ELISA. Results of our study supported previous reports confirming Dsg 1 and Dsg 3 ELISA to be a sensitive and specific tool for the diagnosis of PV and PF.