Routine DIC Evaluations Have Questionable Clinical Value in Stable Myelofibrosis

In care of patients who have clinically stable myelofibrosis, ordering routine hemostasis tests for disseminated intravascular coagulation (DIC) may not be advantageous, according to study findings presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

“This study showed that routinely ordering hemostasis tests to detect overt or non-overt DIC in stable patients without clinical symptoms may not contribute to patient management,” the investigators wrote.

The study retrospectively evaluated 37 outpatients with a median age of 63 years and primary myelofibrosis, post–essential thrombocytosis, or post–polycythemia vera. The patients had undergone routine hemostasis testing from January 2023 to January 2024 in the form of activated partial thromboplastin time, D-dimer, fibrinogen, international normalized ratio, or prothrombin time testing.

All of the patients were clinically stable, and none had clinical signs associated with DIC, such as bleeding, fever, or hypotension.

Thrombocytopenia was detected in ten patients, but it was attributed to bone marrow failure. Moreover, excluding platelet count findings, none of the patients met the International Society on Thrombosis and Haemostasis criteria for overt DIC.

Non-overt DIC was detected in three patients, but all had a history of chronic liver disease and thrombosis. All were also receiving anticoagulation, and the investigators proposed that could have been the cause.

The investigators explained that they plan to explore this issue in larger study cohorts. Additionally, “[w]e have planned to evaluate the frequency of DIC and accompanying causes in symptomatic patients with myelofibrosis using new scoring systems developed specifically for hematologic neoplasias with disease-related thrombocytopenia.”

Reference

Aydın MS, Kalacı Katayıfçı G, Ceran F, et al. Is it necessary to evaluate routine hemostasis tests in myelofibrosis? Abstract #MPN-172. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.