Oxidative Stress in Older Patients with BCR-ABL Negative MPN

By Patrick Daly - Last Updated: December 20, 2021

Essential thrombocytosis (ET), polycythemia vera (PV), and primary myelofibrosis (PM) are BCR-ABL–negative myeloproliferative neoplasms (MPN) with the potential to develop into acute leukemia. The risk of progression is increased by oxidative stress and some genetic mutations. As oxidative stress increases with age, and the median age of patients with ET, PV, and PM is expected to soon pass 65 years, a research team led by Mahmut B. Koyuncu examined oxidative stress parameters in older patients with MPN. Their article, published in Clinical Laboratory, reported that serum ischemia modified albumin (IMA) and thiol levels are significantly changed in older patients with BCR-ABL–negative MPN.

Interestingly, the authors observed that changes in these markers were independent of age. Additionally, the researchers found that disease–associated mutations, such as ASXL1, are also able to affect IMA and thiol serum levels.

The study was conducted on a total of 160 patients, of which 57 patients had ET, 52 had PM, and 51 had PV, as well as 56 health controls. All study participants were aged 65 years and over. IMA and native thiol, total thiol, and disulfide parameters were assessed in serum samples taken at the time of diagnosis.

Compared to the control group, patients with MPN had higher levels of IMA and lower levels of thiol in their serum samples (P <0.001). When the researchers assessed by disease subgroups, the highest IMA levels and lowest thiol levels were observed in patients with PM (P <0.001). Additionally, higher IMA and lower native thiol levels were reported in patients with the ASXL1 mutation (P <0.001).

The authors hoped that their findings could help provide insight and guide care in this aging population of individuals with ET, PV, or PM.