Platelet kinetic studies in patients with idiopathic thrombocytopenic purpura

Louwes, H; Lathori, Oscar A.Zeinali; Vellenga, Edo; Wolf, Jtm de

doi:10.1016/s0002-9343(99)00054-6

Cited by 89 publications

(82 citation statements)

References 16 publications

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“…In addition, patients with a decreased PPR showed significantly less splenic sequestration and a significantly longer mean platelet lifespan than patients with a normal or increased PPR. These findings are consistent with previous studies [8,[28][29][30] and further underscore the heterogeneity of the disease. Thus, in patients with a normal or elevated PPR, increased peripheral destruction of platelets contributes relatively more to thrombocytopenia than suppressed production, which is reflected by a shorter mean platelet lifespan and a higher rate of splenic uptake.…”

Section: Discussionsupporting

confidence: 93%

“…In autoimmune hemolytic anemia, the compensatory reaction is much more pronounced, except when circulating antibodies are directed to normoblasts [31]. Previous studies have shown that, in the majority of ITP patients, the PPR is either reduced or normal [28,30,[32][33][34][35][36]. Additional support for a suppressed platelet production in ITP comes from in vitro studies showing that megakaryocyte production and maturation can be inhibited by antiplatelet antibodies [1,2,37].…”

Section: Discussionmentioning

confidence: 99%

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Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura

et al. 2008

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The predictive value of clinical and platelet kinetic parameters for treatment outcome in idiopathic thrombocytopenic purpura (ITP) was investigated in 75 patients with platelets ≤20×10 9 /L. The platelet kinetic studies showed that the platelet production rate (PPR) was decreased (<100×10 9 /day), normal, or increased (>355×10 9 /day) in 33%, 48%, and 19% of patients, respectively. All patients started with prednisone at diagnosis (1 mg/kg/day). Initial complete and partial response (CR/PR) rate was 84% and a durable CR/PR (≥6 months without treatment) was attained in 44% of the patients. Durable CR/PR was noticed in 64% of the patients with decreased PPR during a median followup time without treatment of 81 (range 18-92) months, compared to 34% of the patients with normal or increased PPR during a median follow-up time without treatment of 141 (range 10-284) months (p=0.03). Splenectomy was performed in 32% of patients with decreased PPR and in 62% of patients with normal or increased PPR (p=0.03). In conclusion, ITP patients with suppressed PPR have a significant higher durable CR/PR rate to prednisone therapy and are less frequently exposed to splenectomy than those with a normal or increased PPR.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura

et al. 2008

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“…However, some evidence shows that ITP is also a matter of impaired platelet production. 6,7 Suboptimal platelet production and relatively low thrombopoietin levels in ITP patients would be consistent with an important role for thrombopoietic agents in ITP management.…”

Section: Introductionmentioning

confidence: 80%

Romiplostim safety and efficacy for immune thrombocytopenia in clinical practice: 2-year results of 72 adults in a romiplostim compassionate-use program

Khellaf

Michel

Quittet

et al. 2011

Blood

102

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“…The number of megakaryocytes on bone marrow films was rated as described elsewhere. 20 Thirty randomly selected high-power fields were examined by three independent observers, and the results were calculated as the mean of these values. One megakaryocyte per 45 low power fields was regarded as megakaryocytic hypoplasia.…”

Section: Bone Marrow Evaluationmentioning

confidence: 99%

Prolonged thrombocytopenia after allogeneic hematopoietic stem cell transplantation: associations with impaired platelet production and increased platelet turnover

Yamazaki

Kuwana

Mori

et al. 2006

Bone Marrow Transplant

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To evaluate the mechanisms underlying prolonged thrombocytopenia after allogeneic hematopoietic stem cell transplantation (SCT), an index for plasma glycocalicin normalized for the individual platelet count (GCI), plasma thrombopoietin (TPO), and circulating B cells producing anti-GPIIb-IIIa antibodies were measured in 50 SCT recipients with or without prolonged thrombocytopenia, 42 patients with idiopathic thrombocytopenic purpura, nine patients with aplastic anemia, and 22 healthy individuals. All three indices were significantly higher in the SCT recipients with thrombocytopenia than in those without (Po0.01 for all comparisons), and were significantly correlated with the platelet count in SCT recipients.Stepwise multiple regression analysis of the samples from the SCT recipients revealed that GCI and TPO independently pointed to specific mechanisms of thrombocytopenia. The GCI and TPO status in SCT recipients with thrombocytopenia had a pattern similar to that seen in aplastic anemia, suggesting a major role for impaired thrombopoiesis. An antiplatelet antibody response was frequently detected in SCT recipients, but the development of thrombocytopenia is likely to depend on additional factors, such as reticuloendothelial function. In summary, post transplant prolonged thrombocytopenia is associated with complex mechanisms, including impaired thrombopoiesis and increased platelet turnover.

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Platelet kinetic studies in patients with idiopathic thrombocytopenic purpura

Cited by 89 publications

References 16 publications

Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura

Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura

Romiplostim safety and efficacy for immune thrombocytopenia in clinical practice: 2-year results of 72 adults in a romiplostim compassionate-use program

Prolonged thrombocytopenia after allogeneic hematopoietic stem cell transplantation: associations with impaired platelet production and increased platelet turnover

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