Assessment of platelet reactivity after the anthracycline-based chemotherapy via mean platelet volume: Does it act on anthracycline-induced cardiotoxicity?

Aim: Anthracycline-induced cardiotoxicity is the most frequent dose-limited toxicity. There has been numerous hypothesis about this matter. As an indicator of platelet size, mean platelet volume (MPV) is correlated with platelet reactivity, aggregation, and long-term atherosclerosis. We aimed to study whether the anthracycline triggers the elevation of MPV. Material and Method: Patients who had breast carcinoma and received anthracycline-based chemotherapy for only adjuvant setting were included. Age, disease stage, history of diabetes mellitus (DM), hypertension (HT) and body mass index (BMI) were recorded. Patients with systemic inflammatory rheumatic disorders, the symptoms of infectious diseases, cytopenia after the chemotherapyand, BMI over 40 and metastatic disease were excluded. Blood samples were collected for initial MPV value and after four cycles of adjuvant anthracycline treatment. Statistical significance of the associations was analyzed using Pearson correlation, Student's t, ANOVA tests and Wilcoxon signed-rank test. Results: Three hundred operated breast cancer patients were recruited in this study. Mean age was 49.1 (20-77). There was no significant correlation between age and initial MPV (r=-1.111, p=0.056) or between BMI and initial MPV (r=0.023, p=0.697). Stage, DM, and HT did not affect initial MPV levels. Initial median MPV was 9.1 (6.2-12.8), and the last median MPV was 9.2 (6.1-12.9). According to Wilcoxon signed ranks test, positive ranks were found in 151 patients (p=0.003, Z=-3,002, based on positive ranks) after anthracycline therapy. Discussion: Anthracycline causes elevation in MPV value which is a marker of thrombocyte reactivation and atherosclerosis. This might be responsible for the possible long-term cardiotoxicity of anthracyclines.