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The risk of major thrombosis is higher in patients with ET who are older than 60 years and who have had a previous occlusive event. In this high-risk group, the non alkylating agent hydroxyurea significantly reduces the rate of vascular complications and is the treatment of choice. In the present study, treatment with hydroxyurea affected, through not significantly, the patients' thrombin generation or PPL assay values, this supporting other clinical and biological data [16, 21, 22]. The influence was seen only on the kinetic parameters of thrombin generation (lag-time and ttp), which are considered to reflect TF activity, http://www.selleckchem.com/products/Cyclopamine.html but not on ETP and peak height. We cannot exclude that some of the antithrombotic effect of hydroxyurea described in patients may due to activation via a non-TF or non-PPL MP route so that it would not been seen by this study. We could provide some evidence that the increased procoagulant activity of plasma was MP-related as removal of part of the MP population significantly reduced plasma procoagulant activity in both thrombin generation and PPL assays. The phenomenon was observed in plasma of both patients and controls and abolished the differences between the two groups. Interestingly, MP-removal reduced the thrombin generation capacity by at least 85%, while only a 25% reduction was reached by the PPL assay. The present data are in agreement with previous observation http://www.selleckchem.com/products/BI-2536.html showing that high speed centrifugation abolished thrombin generation capacity of plasma supernatants [23]. On this basis, it seems that the thrombin generation assay represents a more sensitive measure of procoagulant activity of MP carrying active TF than the PPL assay. In the thrombin generation assay used in this study, activation of plasma coagulation initiated by the addition of alone Ca2+, therefore, it is sensitive to all determinants (i.e., TF or PPL) present in the samples. Differently, the PPL assay is insensitive to TF and only measures PPL. Our data support findings demonstrating that TF and PPL has a much greater prothrombotic effect than PPL alone [11]. However, the fact that MP-removal reduced the PPL activity by 25% support the concept that also PPL can play an important role in the procoagulant http://www.selleck.cn/products/gsk126.html activity of MP of our samples. That the two assays are related, but are not measuring the same coagulant determinants, is also supported by the fact that correlations between PPL assay and thrombin generation parameters are not very strict (R?