Elevated P-RBC complexes are associated with thrombotic risk and diagnostic potential in myeloproliferative neoplasms: a retrospective cohort study.

Authors

Xiaonan Niu, Caihong Jia, Yuefan Ma, Xuezhi Huang, Chao Li

Published in

American journal of translational research. Volume 18. Issue 8. Pages 6535-6549. Epub Aug 15, 2026.

Abstract

Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders characterized by excessive myeloid proliferation. The impaired clearance of senescent erythrocytes is a key pathological feature, yet its mechanisms remain unclear. Pro-phagocytic platelet-erythrocyte (P-RBC) complexes may represent a novel intercellular interaction involved in this process.
To investigate the levels of P-RBC complexes in MPN patients, their association with clinical characteristics and thrombotic risk, and their potential diagnostic value.
In this retrospective cohort study, 152 MPN patients (including polycythemia vera [PV], essential thrombocythemia [ET], and primary myelofibrosis [PMF]) and 152 healthy controls were enrolled. P-RBC complex levels in peripheral blood were measured using flow cytometry. Correlations with laboratory parameters, thrombotic events, and survival were analyzed.
P-RBC complex levels were significantly higher in MPN patients than in controls (2.76 ± 0.53% vs. 1.28 ± 0.37%, P < 0.001). Levels varied by subtype, with PMF patients showing the highest levels (3.28 ± 0.52%), followed by PV (2.76 ± 0.44%) and ET (2.49 ± 0.39%) (P < 0.001). P-RBC levels positively correlated with hemoglobin (r = 0.456), C-reactive protein (r = 0.291), and lactate dehydrogenase (r = 0.736) (all P < 0.001). Patients with thrombotic events had higher P-RBC levels than those without (3.04 ± 0.70% vs. 2.72 ± 0.48%, P = 0.009). Multivariate analysis identified P-RBC level as an independent risk factor for thrombosis (OR = 3.07, P = 0.012). Although survival was worse in the high-P-RBC group, the difference was not statistically significant (P = 0.194). ROC analysis showed excellent diagnostic performance for MPNs (AUC = 0.990), with 100.0% sensitivity and 91.4% specificity at a 1.80% cutoff.
P-RBC complexes are significantly elevated in MPN patients and correlate with disease subtype, inflammation, and thrombotic risk. They represent a promising novel biomarker for MPN diagnosis and risk stratification.

PMID:
42764854
Bibliographic data and abstract were imported from PubMed on 21 Sep 2026.

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