The use of antiproteolytic mixture fails to modify the abnormal von Willebrand factor pattern in myeloproliferative disease

Abnormalities of von Willebrand factor, with reduction of higher molecular weight multimers, was described in patients with increased platelet number. We have studied twelve patients with myeloproliferative disease (9 patients with Essential Thrombocytosis and 3 patients with Polycythemia Vera). Blood samples were collected either with citrate and antiproteolytic mixture (EDTA 6 mM, Aprotinin 200 U/ml, N-ethylmaleimide 5 mM in sodium citrate 3.8%). VIIIR: RCoF was found decreased in all patients studied, using both anticoagulants, while VIIIR: Ag was within normal range. Higher molecular weight multimers were found decreased or absent both in samples collected with citrate and in those collected using the antiproteolytic mixture. These data suggested that von Willebrand factor abnormalities observed in myeloproliferative disease are not due to a proteolytic degradation that's supposed to happen in vitro during blood samples collection and manipulation.