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PubMed2004

Serum vascular endothelial growth factor per platelet count in hepatocellular carcinoma: correlations with clinical parameters and survival.

BACKGROUND: Platelets have been reported to act as transporters of tumor-originated vascular endothelial growth factor (VEGF), contributing to tumor angiogenesis and progression. Serum VEGF per platelet count, as an indirect theoretical estimate of VEGF in platelets, may predict the malignant potential of tumors. However, its prognostic significance is still unclear in hepatocellular carcinoma (HCC), a highly vascular tumor. METHODS: Serum VEGF was measured by enzyme-linked immunosorbent assay. We compared serum VEGF, platelet count and serum VEGF per platelet count in 52 HCC patients, 26 liver cirrhosis patients and 30 healthy controls. The relation of serum VEGF per platelet count with clinicopathologic variables of HCC patients and the prognostic significance were investigated. RESULTS: Serum VEGF per platelet count in HCC patients was higher than in liver cirrhosis patients and healthy controls (P < 0.01). There was a statistically significant correlation between serum VEGF and platelet count in HCC patients (r = 0.751, P < 0.01). Serum VEGF per platelet count was higher in patients with advanced stage and portal vein thrombosis (P < 0.01). Patients with high serum VEGF per platelet count (>1.4 pg/10(6)) showed poor response to treatment and shorter overall survival (P < 0.01). Serum VEGF per platelet count was an independent prognostic factor with the presence of portal vein thrombosis (P < 0.01). CONCLUSIONS: Serum VEGF per platelet count could be a feasible prognostic indicator during the follow-up of patients with HCC.

Adult↗

PubMed2004

Erythropoietin increases platelet reactivity and platelet counts in patients with alcoholic liver cirrhosis: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Patients with liver cirrhosis have a complex haemostasis disturbance including thrombocytopenia and abnormal bleeding time. Erythropoietin is the primary stimulator for erythrocyte production and also induces megakaryocyte formation. In healthy men erythropoietin increased platelet count and platelet reactivity. AIM: As patients with liver cirrhosis often undergo invasive procedures, we were interested to study whether erythropoietin could improve platelet function in addition to thrombocytopenia. METHODS: In total, 22 thrombocytopenic (platelet counts < 120 g/L) patients with alcoholic liver cirrhosis received either 100 IE/kg erythropoietin or placebo on days 1, 3 and 5 in a 2:1 randomized, placebo-controlled double-blind fashion. Platelet counts and platelet reactivity (activator-stimulated expression of P-selectin on platelets measured by flow cytometry) were determined on study days 1, 3, 5 and 9. RESULTS: Median platelet count was 80 g/L which is borderline for major elective surgical interventions. Baseline values were not different between groups (P > 0.05). Treatment with erythropoietin increased platelet count by 25% (P = 0.01) and platelet reactivity twofold (P < 0.01) vs. baseline. The increase in platelet count vs. baseline was more pronounced in patients with platelet counts <80 g/L. No significant effect was observed in the placebo group. CONCLUSIONS: Treatment with erythropoietin significantly increased platelet counts and platelet reactivity in patients with alcoholic liver cirrhosis. Preoperative treatment with erythropoietin is therefore expected to yield higher platelet levels and better platelet function.

Adult↗

PubMed2001

The significance of platelet counts in coagulation studies.

Traditionally, the platelet count recommended for coagulation studies has been less than 10 x 10(9)/L, but the documentation for this is obscure. In the present study, platelet rich plasma (PRPs) and platelet poor plasmas (PPPs) were prepared from the same blood specimen to determine prothrombin times (PTs), International Normalized Ratios (INRs), partial thromboplastin times (PTTs), and their results compared. The measurements of all three of these parameters are not statistically or clinically significant in 100 paired comparisons. Incremented platelet count studies, selected by the number of platelets in the PRPs, showed that platelet counts of at least 199 x 10(9)/L, or perhaps even higher, did not compromise the results of PTs, INRs or PTTs. Such increased platelet counts, however, cannot be tolerated in the various studies for antiphospholipid antibodies, the Lupus Anticoagulant (LAC), or when monitoring heparin therapy with PTTs. Here, the < 10 x 10(9)/L platelet levels must be respected; otherwise the tests would be compromised by platelet-liberated phospholipid (Triplett, Brand et al., 1983) or by Platelet Factor 4, respectively.

Blood Coagulation Tests↗

PubMed2003

Platelet count and sepsis in very low birth weight neonates: is there an organism-specific response?

OBJECTIVE: Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with culture-proven sepsis to determine if there are organism-specific platelet responses. STUDY DESIGN: We analyzed a cohort of all VLBW neonates (birthweight <1500 g) born over a 4-year period and admitted to a single level III neonatal intensive care unit (N = 943). Thrombocytopenia was defined as a platelet count <100,000/mm(3). Platelet count, nadir, duration of thrombocytopenia, and mean platelet volume (MPV) were examined during episodes of culture-proven sepsis. Analysis of variance, Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to compare groups, and data are expressed as mean +/- standard deviation. RESULTS: Sepsis was diagnosed in 154 (16%) of 943 patients in the study population. Of the sepsis episodes, 54% were associated with thrombocytopenia and 61% with an elevation in MPV. Infections were grouped by organism type: Gram-positive bacteria (117/154, 76%), Gram-negative bacteria (24/154, 16%), and fungi (13/154, 8%). When compared with patients with Gram-positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower initial platelet count, a lower platelet nadir, a higher incidence of thrombocytopenia, and a greater duration of thrombocytopenia. The decrease in platelet count from baseline was also significantly less in the Gram-positive infections than in the fungal infections. Although there was an overall increase in MPV from baseline, there were no differences between groups. CONCLUSIONS: In our population of VLBW infants, sepsis is frequently associated with thrombocytopenia and an elevation in MPV. However, fungal and Gram-negative pathogens are associated with a lower platelet count and more prolonged thrombocytopenia compared with Gram-positive pathogens. We conclude that common pathogens causing sepsis have different effects on platelet kinetics.

Adult↗

PubMed1990

Fetal platelet counts in thrombocytopenic pregnancy.

Fetal platelet counts were assessed by percutaneous umbilical blood sampling in 64 pregnancies (62 women) with maternal thrombocytopenia. In 33 pregnancies associated with chronic immune thrombocytopenia, 11 of the fetuses had platelet counts below 150 x 10(9)/l and 4 were severely thrombocytopenic (less than 50 x 10(9)/l). In 31 pregnancies with symptomless maternal thrombocytopenia as an incidental finding, 4 fetuses were thrombocytopenic, 1 of them severely. Maternal indices, including antiplatelet antibodies, did not correlate with risk of fetal thrombocytopenia; and in those with repeat measurements there was no evidence of benefit from treatment with either corticosteroids (4 cases) or intravenous immunoglobulin (3 cases). Percutaneous umbilical blood sampling, a safe procedure in experienced hands, provides accurate platelet counts in thrombocytopenic pregnancy, as an aid to decisions on mode of delivery and to assessment of treatments.

Blood Specimen Collection↗

PubMed1999

Evaluation of the use of a platelet-counting tool in plateletpheresis.

OBJECTIVE: For years, blood transfusion centers in Taiwan have used the Quantitative Buffy Coat (QBC(R)) Hematology System for platelet counts on capillary blood samples in the laboratory screening of apheresis donors. The system has not been evaluated for the prediction of yields in plateletpheresis. Methods : The QBC instrument was evaluated for reproducibility of platelet counts and compared with five electronic cell counters. We also collected both capillary and venous blood from voluntary donors before donation and counted platelets, comparing the QBC system and an electronic blood cell counter (Sysmex K1000). The correlation between donors' predonation platelet counts and plateletpheresis yields was analyzed. RESULTS: The R values for platelet counts between the QBC Hematology System and other electronic counters are lower (0.759-0. 890) than among the electronic counters (0.929-0.973). The mean capillary platelet count and the mean venous platelet count were 241. 9+/-50.3x10(3)/microl and 233.2 +/-47.9x10(3)/microl by the QBC system, and 244.9+/-54.1x10(3)/microl and 218.9+/-46.5x10(3)/microl by the Sysmex K1000, respectively. Linear regression analysis showed that platelet yields correlated well with donors' predonation platelet counts using the Sysmex K1000 counter (R = 0.777- 0.890, p<0.001), but not with the QBC system (R = 0.326 approximately 0.755, p<0.05). CONCLUSION: The QBC Hematology System is not accurate enough to determine predonation platelet counts that are to be used for calculating the number of processing cycles for plateletpheresis.

Electronics↗

PubMed1990

The platelet count in carcinoma of the lung and colon.

Platelet counts were evaluated in 714 patients with advanced non-small cell lung cancer (N-SCLC), small cell carcinoma of the lung (SCCL), and colon cancer entered to a clinical trial. Patients had not received prior chemotherapy. Platelet counts were not different in patients who had received radiation therapy prior to entry to the study. In comparison to the other tumor types, patients with N-SCLC demonstrated an increased prevalence of thrombocytosis (counts greater than 400,000/mm3), higher platelet counts at the time of entry to the study, higher over all mean platelet counts, relative preservation of high platelet levels during disease progression, and no relationship between platelet numbers and the amount of chemotherapy given. By contrast, platelet counts in patients with SCCL were negatively correlated with the absolute amount of cyclophosphamide and adriamycin given, and declined most dramatically with disease progression and death. Platelet numbers did not correlate with fibrinopeptide A or fibrin split product levels suggesting that disseminated intravascular coagulation or fibrinolysis may have had less influence on platelet numbers than certain other factors. By contrast, significant correlations were found for all three tumor types between platelet numbers and other indicators of bone marrow function including anemia, total leukocyte count, and absolute neutrophil count; and the fibrinogen level. Based upon these findings, we postulate that the host response to malignancy, possibly in the form of production of bone marrow-stimulating cytokines, may play a prominent role in regulation of platelet counts in these (and perhaps other) neoplasms, and that a particularly prominent and persistent degree of marrow stimulation exists in patients with N-SCLC.

Carcinoma, Non-Small-Cell Lung↗

PubMed2004

Effects of biological variations on platelet count in healthy subjects in China.

The effects of biological variations on platelet counts were investigated in 694 healthy subjects aged 18 to 60 years living in three cities including Chengdu (Sichuan Province), Suzhou (Jiangsu Province) and Harbin (Heilongjang Province) in China. Platelet counts in healthy subjects were significantly lower in Chengdu (52-202 x 10(9)/L) and Suzhou (60-259 x 10(9)/L) than in Harbin (154-348 x 10(9)/L) (p <0.0001), but the mean platelet volume (MPV) determined concurrently was negatively correlated with platelet count, the MPV values were significantly higher in Chengdu (11.8-15.6 fl) and Suzhou (10.9-15.8 fl) than in Harbin (9.5 approximately 12.9 fl) (p < 0.0001). Platelet counts were significantly higher in summer (73-289 x 10(9)/L) than in winter (52-202 x 10(9)/L) (p <0.0001), but the MPV values were lower in summer (11.2-14.7 fl) than in winter (11.8-15.6 fl) (p <0.05) in Chengdu. Platelet associated immunoglobulin (PA-IgG) in Chengdu was revealed to be significantly higher in the low platelet count group (<150 x 10(9)/L, 13.5 +/- 7.1 ng/10(7) PLT) than in the normal platelet count group (> or =150 x 10(9)/L, 8.3 +/- 2.7 ng/10(7) PLT) (p <0.0001). Similar results were observed in Suzhou for the reticulated platelet ratio, which was significantly higher in the low platelet count group (19.5 +/- 7.1%) than in the normal platelet count group (11.6 +/- 2.7%) (p <0.01). The bleeding time in Chengdu showed a significantly longer time in the low platelet count group (8.6 +/- 2.3 min) than in the normal platelet count group (6.0 +/- 1.2 min)(p <0.01). With regard to the effects of lipids on platelet counts, the HDL values were significantly higher in the normal platelet count group (1.60 +/- 0.76 mmol/L) than the low platelet count group (1.23 +/- 0.31 mmol/L) (p <0.01); but no significant differences in cholesterol and triglycerides values between the normal and low platelet count groups (p >0.05) were recorded. These findings suggest that the platelet counts could be greatly influenced in healthy subjects by biological variations such as geographical, seasonal, and lipid variations.

Adolescent↗

PubMed1992

[Studies on plasma beta-thromboglobulin, thromboxane A2, prostaglandin I2 concentration and platelet count in liver diseases].

We measured blood platelet count and plasma beta-thromboglobulin concentration in 67 patients with acute or chronic liver diseases. Plasma TXB2 and 6-keto-PGF1a concentration were also measured in these patients. The results showed that blood platelet count of less than 100 x 10(9)/L was found in 14% of the patients with acute hepatitis, 23% with chronic hepatitis, 67% with hepatic cirrhosis but without splenectomy and 40% with primary liver carcinoma. Platelet count is lowest in patients with hepatic cirrhosis without splenectomy but normal in patients with hepatic cirrhosis after splenectomy. Plasma beta-TG concentration increased in patients with acute or chronic liver diseases. A negative correlation was found between beta-TG concentration and platelet count in chronic liver diseases. It is suggested that platelet is in activated state in vivo and this may be one of the important reasons for both decrease of platelet count and impairment of platelet function. Plasma TXB2 concentration increased in chronic liver diseases, while plasma 6-keto-PGF1a concentration decreased. The balance between TXA2 and PGI2 is upset; this may be an important mechanism for activation of platelets in vivo.

6-Ketoprostaglandin F1 alpha↗

PubMed1978

Effects of short-term hypoxia on platelet counts of mice.

Recent studies have shown that long-term hypoxia causes decreased platelet counts in mice and short-term hypoxia increased platelet counts. In an attempt to explain the mechanism that increases platelet counts of mice after exposure to short-term hypoxia, we measured platelet counts, total circulating platelet counts (TCPC), total circulating platelet masses (TCPM), percentages of 35S incorporation, and platelet sizes. Platelet counts, as well as TCPC and TCPM of mice, increased after 1-3 days of hypoxia, but these values were decreased after 6-7 days of hypoxia. Although platelet counts were increased in hypoxic mice, the percentage 35S incorporation into platelets and platelet sizes did not show a concurrent increase. After 6 days of hypoxia, average platelet diameters began to increase as platelet counts decreased. Splenic release did not account for the increase in platelet counts of mice after short-term hypoxia. It seems possible, therefore, that megakaryocytes "shed" platelets into the circulation in response to hypoxia. The platelets that enter the circulation in response to short-term hypoxia are smaller and incorporate less 35S than platelets that are produced in response to acute thrombocytopenia.

Animals↗

PubMed2003

Is automated platelet counting still a problem in thrombocytopenic blood?

CONTEXT: Reliable platelet counting is crucial for indicating prophylactic platelet transfusion in thrombocytopenic patients. OBJECTIVE: To evaluate the precision and accuracy of platelet counting for thrombocytopenic patients, using four different automated counters in comparison with the Brecher & Cronkite reference method recommended by the International Committee for Standardization in Hematology (ICSH). TYPE OF STUDY: Automated platelet counting assessment in thrombocytopenic patients. SETTING: Hematology Laboratory, Hospital do Servidor Público Estadual de São Paulo, and the Hematology Division of Instituto Adolfo Lutz, São Paulo, SP, Brazil. MAIN MEASUREMENTS: Brecher & Cronkite reference method and four different automated platelet counters. PARTICIPANTS: 43 thrombocytopenic patients with platelet counts of less than 30,000/microliter. RESULTS: The ADVIA-120 (Bayer), Coulter STKS, H1 System (Technicom-Bayer) and Coulter T-890 automatic instruments presented great precision and accuracy in relation to laboratory thrombocytopenic samples obtained by diluting blood from normal donors. However, when thrombocytopenic patients were investigated, all the counters except ADVIA (which is based on volume and refraction index) showed low accuracy when compared to the Brecher & Cronkite reference method (ICSH). The ADVIA counter showed high correlation (r = 0.974). However, all counters showed flags in thrombocytopenic samples. CONCLUSION: The Brecher & Cronkite reference method should always be indicated in thrombocytopenic patients for platelet counts below 30,000 plt/microliter obtained in one dimensional counters.

Brazil↗

PubMedDate not supplied

Thrombopoietin level in young patients is related to megakaryocyte frequency and platelet count.

PURPOSE: To examine the relationships among platelet counts, bone marrow megakaryocyte frequency, and circulating thrombopoietin (TPO) levels. PATIENTS AND METHODS: TPO levels in 17 children and one young adult with chronic or recurrent thrombocytopenia were measured by ELISA and megakaryocyte frequency was analyzed by light microscopy. Three groups of patients were studied: Group I patients had aplastic anemia and absent or decreased megakaryocytes; Group II patients had intermittent periods of chemotherapy-induced thrombocytopenia; and Group III patients had normal or increased megakaryocytes. Controls consisted of 77 healthy adults. RESULTS: Patients in Group I had markedly increased TPO levels compared to normal controls. Their levels were significantly different (p = 0.03) from those of patients in Group III. The latter had normal or only mildly increased TPO levels except for one patient with myelodysplastic syndrome. Patients in Group II had markedly elevated TPO levels. After their bone marrow and platelet counts recovered from chemotherapy, their TPO levels decreased. In all three groups, a transient increase in platelet count (e.g., after platelet transfusion or anti-D immune globulin therapy) was associated with a moderate decrease in TPO. CONCLUSIONS: From this study, three conclusions can be made: 1) TPO levels are inversely related to megakaryocyte frequency; 2) platelet counts have a modest influence on TPO level; and 3) TPO levels may have clinical utility in diagnosis and management and further our understanding of the pathobiology of the disorders that cause thrombocytopenia.

Adolescent↗

PubMed1987

Free platelet count and size distribution during C1q inhibition of collagen-induced platelet aggregation.

Electronic free platelet counting was more sensitive than turbidimetry to detect collagen-induced platelet activation in human platelet-rich plasma. Purified human C1q exhibited a greater inhibitory effect on collagen-induced platelet aggregation in turbidimetry than free platelet counting. Because the change from small to large platelet aggregates is responsible for the continuing increase in light transmission, C1q was likely more capable of blocking the formation of large platelet aggregates than the formation of small aggregates from single platelets. The rate of change by collagen in light transmission and free platelet count was reduced in the presence of C1q but the timing of the peak response remained the same. Electronic platelet sizing revealed that the volume of single platelets transiently increased during the turbidimetric "lag phase". The mean, mode and median volume of the remaining free platelets then decreased, suggesting a selective loss of large, functionally more active platelets and/or platelet degranulation. C1q had no effect on the volume increment during the "lag phase", but reduced the subsequent fall in the volume of free platelets.

Adult↗

PubMed2001

Sustained decreases in platelet count associated with multiple, regular plateletpheresis donations.

BACKGROUND: Transient but significant decreases in platelet counts have been documented to occur in donors undergoing single and serial short-term plateletpheresis collections. The effect of long-term regular plateletpheresis on donor platelet counts has not been characterized. STUDY DESIGN AND METHODS: A retrospective study was performed to evaluate the effects of long-term regular plateletpheresis donation on donor platelet counts. A computerized database containing records of 11,464 apheresis collections from 939 donors over a 4-year period was queried for serial preapheresis platelet counts. Donors were categorized by sex, age, and cumulative number of donations. The average difference in platelet counts (mDeltaPC) between each donor's first and last platelet count during this period was calculated for each category. A subgroup of frequent donors was selected for analysis of mDeltaPC, using the baseline platelet count obtained before the first plateletpheresis procedure. RESULTS: A significant and sustained decrease in platelet count was identified for all donation frequency categories. The frequency of donation correlated directly with decrease in platelet count for all but the highest-frequency donation group, in which deferrals for low platelet count blunted the extent of the mDeltaPC. A mean decrease of 40,000 per microL from baseline occurred in the frequent-donor subgroup. A total of 84 donors (9%) were deferred for low platelet count. The majority returned to donate successfully after temporary deferral. CONCLUSIONS: Regular plateletpheresis donors develop sustained decreases in platelet count. However, clinically significant thrombocytopenia is unusual when rigorous ongoing review and prudent deferral policies are established and followed.

Adult↗

PubMed1993

Sequential changes in the platelet count in patients with symptomatic vasospasm after subarachnoid hemorrhage.

The platelet count in 110 patients with subarachnoid hemorrhage (SAH) was analyzed retrospectively. Changes in the platelet count in 102 patients undergoing intracranial aneurysm surgery showed that the minimum platelet count was similar in patients with and without symptomatic vasospasm, but the minimum occurred later in symptomatic vasospasm patients, regardless of Hunt and Hess grade or operation timing. Sixty-five of 67 non-symptomatic vasospasm patients (97%) showed the minimum platelet count within 4 days of SAH and two (3%) on the 5th day. In contrast, only 10 of 35 symptomatic vasospasm patients (29%) showed a minimum platelet count within 4 days after SAH and 25 (71%) between the 5th and 11th days. Analysis of the eight patients not receiving surgery showed that the minimum platelet count occurred 2 days after SAH in two non-symptomatic vasospasm patients, but after the 5th day in five of six symptomatic vasospasm patients. Therefore, monitoring of the platelet count can provide an indicator of the occurrence of symptomatic vasospasm.

Adult↗

PubMed1999

Quality control and quality assurance of platelet counting.

The accuracy and precision of platelet counting using new automated blood cell analyzers is satisfactory. However, there are several errors in automated platelet counting. Careful review of blood cell histograms and peripheral blood films is necessary to avoid false platelet counts as well as to ensure a good quality control regimen.

Automation↗

PubMed1997

Thrombotic complications in essential thrombocythemia with relatively low platelet counts.

Essential thrombocythemia (ET) is often associated with thrombotic and hemorrhagic complications, mostly at platelet counts exceeding 600 x 10(9)/L. There are, however, a few reports of such complications in ET at considerably lower platelet levels and the therapeutic approach to affected patients with relatively low platelet counts is still controversial. In the present study, the first to directly address the issue of hemostatic manifestations at relatively low platelet counts, we have determined the lowest platelet counts associated with such manifestations in 56 consecutive ET patients. Clinical manifestations related to ET were recorded in 46 (82%) patients. Of the symptomatic patients, 32 (70%) had symptoms at platelet counts lower than 600 x 10(9)/L, 23 (50%) at counts lower than 500 x 10(9)/L, 10 (22%) at counts lower than 400 x 10(9)/L, and 6 patients (13%) at platelet counts as low as 300-350 x 10(9)/L. Severe complications occurred at platelet counts lower than 600 x 10(9)/L in 10 patients (22%), lower than 500 x 10(9)/L in 7 (15%), and at lower than 400 x 10(9)/L in 2 (4%). Thrombotic neurologic symptoms were the most common (31 patients, 67%), followed by peripheral vascular symptoms (17 patients, 37%); hemorrhagic complications were relatively rare (3 patients, 7%). In most cases, cessation or improvement of clinical manifestations was observed only after further reduction in platelet counts. In conclusion, thrombotic manifestations, including severe ones, are not uncommon in ET at relatively low platelet counts. We recommend that symptomatic patients with relatively low platelet counts be treated and the platelet counts further reduced well into the lower normal range.

Adult↗

PubMed1992

The relationship between increased platelet count and megakaryocyte size in bronchial carcinoma.

This study investigates megakaryocyte size in bronchial carcinoma and its relationship to platelet count, mean platelet volume and platelet function, the latter determined in vivo by measurement of the cutaneous bleeding time. Measurements were performed in 19 patients with bronchial carcinoma and 11 patients with a hiatus hernia (controls). Platelet count (335 +/- 123 v. 241 +/- 72 x 10(9)/l) and megakaryocyte total area (772 +/- 135 v. 666 +/- 105 microns 2) (mean +/- standard deviation) were both significantly increased in patients with bronchial carcinoma when compared to controls whilst the bleeding time was shorter in the patient group (253 +/- 116 v. 321 +/- 80 s). Patients with bronchial carcinoma were older (60.2 +/- 8.4 v. 48.8 +/- 13.2 years) and smoked more heavily (760 +/- 511 v. 92 +/- 175 cigarette years) than controls. Megakaryocyte size, platelet count and bleeding time all correlated with smoking habit (r = 0.395, P = 0.031; r = 0.622, P less than 0.001; r = 0.515, P = 0.004 respectively). There were no statistically significant differences between the groups with respect to gender or mean platelet volume. When considering all patients, significant correlations existed between platelet count and megakaryocyte area (r = 0.400, P = 0.029), and bleeding time and megakaryocyte area (r = -0.365, P = 0.047). The megakaryocyte nuclear and cytoplasmic areas were positively correlated (r = 0.855, P less than 0.001). This study suggests that the elevated platelet count in patients with bronchial carcinoma is mediated by an increase in the size of bone marrow megakaryocytes although the results are compounded by the association between smoking and megakaryocyte/platelet parameters.

Bleeding Time↗