{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:19:44Z","timestamp":1787019584141,"version":"build-2736575974"},"reference-count":67,"publisher":"American Society of Hematology","issue":"21","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11,12]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Clinical features in patients with the B-cell lymphoma, Waldenstr\u00f6m macroglobulinemia (WM), include cytopenias, immunoglobulin M (IgM)\u2013mediated hyperviscosity, fatigue, bleeding, and bruising. Therapeutics such as Bruton's tyrosine kinase inhibitors (BTKis) exacerbate bleeding risk. Abnormal hemostasis arising from platelet dysfunction, altered coagulation or vascular impairment have not yet been investigated in patients with WM. Therefore, this study aimed to evaluate hemostatic dysfunction in samples from these patients. Whole blood (WB) samples were collected from 14 patients with WM not receiving therapy, 5 patients receiving BTKis and 15 healthy donors (HDs). Platelet receptor levels and reticulation were measured by flow cytometry, plasma thrombin generation with or without platelets by fluorescence resonance energy transfer assay, WB clotting potential by rotational thromboelastometry, and plasma soluble glycoprotein VI (sGPVI) and serum thrombopoietin (TPO) by enzyme-linked immunosorbent assay. Donor platelet spreading, aggregation, and ability to accelerate thrombin generation in the presence of WM-derived IgM were assessed. WM platelet receptor levels, responses to physiological agonists, and plasma sGPVI were within normal ranges. WM platelets had reduced reticulation (P\u00a0=\u00a0.0012) whereas serum TPO levels were increased (P\u00a0=\u00a0.0040). WM plasma displayed slower thrombin generation (P\u00a0=\u00a0.0080) and WM platelets contributed less to endogenous thrombin potential (ETP; P\u00a0=\u00a0.0312). HD plasma or platelets incubated with IgM (50-60\u00a0mg\/mL) displayed reduced spreading (P\u00a0=\u00a0.0002), aggregation (P\u00a0&amp;lt; .0001), and ETP (P\u00a0=\u00a0.0081). Thus, alterations to thrombin potential and WB coagulation were detected in WM samples. WM IgM significantly impaired hemostasis in\u00a0vitro. Platelet and coagulation properties are disturbed in patients with well-managed WM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/bloodadvances.2024014190","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T11:20:55Z","timestamp":1729855255000},"page":"5542-5555","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":5,"title":["Patients with Waldenstr\u00f6m macroglobulinemia have impaired platelet and coagulation function"],"prefix":"10.1182","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7489-812X","authenticated-orcid":false,"given":"Simone A.","family":"Brysland","sequence":"first","affiliation":[{"name":"1Division of Genome Science and Cancer, John Curtin School of Medical Research, The Australian National University, Canberra, ACT, 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of Genome Science and Cancer, John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia"},{"name":"4Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4124-4971","authenticated-orcid":false,"given":"Philip J.","family":"Crispin","sequence":"additional","affiliation":[{"name":"2Department of Clinical Haematology, Canberra Health Services, Canberra, ACT, Australia"},{"name":"3School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9453-9688","authenticated-orcid":false,"given":"Elizabeth E.","family":"Gardiner","sequence":"additional","affiliation":[{"name":"1Division of Genome Science and Cancer, John Curtin School of Medical Research, The 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