ABSTRACT
We retrospectively investigated the association between platelet autoantibody specificity and response to intravenous immunoglobulin G (IVIG) in 17 patients with immune thrombocytopenia (ITP). Platelet-associated antibodies against glycoprotein (GP) IIb/IIIa, GPIb/IX, and GPIa/IIa were detected in 13, 10, and 8 patients, respectively. A response occurred in 7 of 7 patients without anti-GPIb/IX, but in only 3 of 10 patients with anti-GPIb/IX (p<0.01). There was no difference in the response rates in patients with or without anti-GPIIb/IIIa or anti-GPIa/IIa. We conclude that ITP patients with anti-GPIb/IX may be less responsive to IVIG.
Subject(s)
Autoantibodies/immunology , Blood Platelets/immunology , Immunoglobulin G/administration & dosage , Immunoglobulin G/therapeutic use , Thrombocytopenia/blood , Thrombocytopenia/drug therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Infusions, Intravenous , Integrin alpha2beta1/blood , Male , Middle Aged , Platelet Glycoprotein GPIIb-IIIa Complex/biosynthesis , Platelet Glycoprotein GPIb-IX Complex/biosynthesis , Retrospective StudiesSubject(s)
Erythropoietin/adverse effects , Granulocyte Colony-Stimulating Factor/adverse effects , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Positron-Emission Tomography , Stomach Neoplasms/diagnostic imaging , Anemia/chemically induced , Anemia/drug therapy , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow/diagnostic imaging , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Epoetin Alfa , Erythropoietin/therapeutic use , Female , Filgrastim , Granulocyte Colony-Stimulating Factor/therapeutic use , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Middle Aged , Neutropenia/chemically induced , Neutropenia/drug therapy , Polyethylene Glycols , Prednisone/administration & dosage , Prednisone/adverse effects , Recombinant Proteins , Rituximab , Stomach Neoplasms/drug therapy , Vincristine/administration & dosage , Vincristine/adverse effectsABSTRACT
Acute myelogenous leukemia with t(8;21)(q22;q22) developed in a 42-yr-old woman having thrombocytopenia with absent radii syndrome (TARS). Standard induction and postremission therapies were safely administered. With each successive chemotherapy, the onset of platelet recovery was not delayed, but peak platelet counts were persistently suppressed. Nine months after achieving complete hematologic and cytogenetic remission, she remains severely thrombocytopenic (platelet count 6-12 x 109/L). She is, however, asymptomatic and transfusion independent. Of interest is the transient normalization of platelet count (rebound relative thrombocytosis). Our report and review of the literature suggests that TARS, contrary to previous belief, may be associated with increased risk of acute leukemia.
