Short-Course Alpha-Interferon Therapy in Severe Unresponsive Immune Thrombocytopenic Purpura

Proctor, SJ; Jackson, GH; Carey, Peter; Stark, A N

doi:10.1016/s0140-6736(88)91766-7

Cited by 36 publications

(9 citation statements)

References 2 publications

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“…1987;Lee et al 1989). It has been postulated that interferon has a depressant effect on B lymphocytes producing an autoantibody (Proctor et al 1988). This is not supported by our study, however, as the one patient who responded to interferon treatment continued to show anti-platelet antibodies.…”

Section: Discussioncontrasting

confidence: 95%

“…Hymes et al (1988) have pointed out that the rapidity with which platelet counts improve after zidovudine treatment could not be explained by zidovudine interfering with production of antibodies or immune-complexes with anti-platelet activity. It has been postulated that interferon has a depressant effect on B lymphocytes producing an autoantibody (Proctor et al 1988). 1987;Lever et a/.…”

Section: Discussionmentioning

confidence: 99%

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Antibodies to platelet glycoproteins in haemophiliacs infected with HIV

Quadri

Lee

Goodall

et al. 2008

Clinical &Amp; Laboratory Haematology

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Summary The techniques of Western blotting and the monoclonal antibody specific immobilization of platelet antigen (MAIPA) assay were used to detect antibodies to platelet glycoproteins in 43 samples of serum from 23 anti‐HIV positive haemophiliacs (8 with severe thrombocytopenia, 6 with moderate thrombocytopenia, and 9 with a normal platelet count), six anti‐HIV negative haemophiliacs and ten controls. Antibodies were present in the majority of anti‐HIV positive patients' sera even before the onset of thrombocytopenia. Thrombocytopenia was associated with an increase in the incidence of antibodies to GPIIIa and GPIb, whereas the antigen most frequently recognized in patients without thrombocytopenia was GPIIb. Anti‐GPIIb and/or GPIIIa reactivity was also seen in three out of the six anti‐HIV negative patients. There was no correlation between the absolute platelet count and the detection of antibodies in either assay. Effective therapy for thrombocytopenia with zidovudine, interferon or splenectomy did not influence the presence of antibody. Eight of nine patients with AIDS were negative in the MAIPA assay, consistent with their depressed immune status. It is concluded that the production of antibodies to platelet membrane glycoprotein in anti‐HIV positive haemophiliacs is influenced by factors other than HIV. The presence of such antibodies is independent of the platelet count and is therefore unlikely to play a causative role in HIV‐related thrombocytopenia.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Antibodies to platelet glycoproteins in haemophiliacs infected with HIV

Quadri

Lee

Goodall

et al. 2008

Clinical &Amp; Laboratory Haematology

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“…Recently, the efficacy of interferon (IFN) alpha-2b for HIV-1-associated thrombocytopenia has been reported (16,17). In 1989, Proctor et al demonstrated that a short course of IFN alpha-2b caused a significant increase in the platelet count in ll of 13 patients with severe steroid-resistant ITP (18,19). Other investigators have performed further trials (20, 21) but could not show a better efficacy rate than Proctor et al Proctor and Jackson summarized earlier reports by classifying patient responses to five categories, demonstrating that the positive response rate was 69% (22).…”

Section: Introductionmentioning

confidence: 99%

Effect of Interferon(IFN) on Refractory Idiopathic Thrombocytopenic Purpura: Administration of 6 Million Units of Recombinant IFN alpha-2b.

Ishii

Uchida

et al. 1992

Intern. Med.

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Five patients (six courses) with refractory idiopathic thrombocytopenic purpura (ITP) were given 6 million units of recombinant interferon (IFN) alpha-2b in 12 doses to achieve an improved response rate compared to previous studies using 3 million units. From the initial IFN administration, the platelet count increased from a pre-treatment level of 20.7 ± 17.7 X 103/ul (mean ± SD) and reached its first peak in weeks 2 or 3 of therapy (p<0.05). In week 5, the platelet count made its second and maximum peak (66.5 ± 57.9 X 103/^l; p < 0.05). A relatively good response of the platelet count (an increase to >50 X 103/ul) was observed in three patients (four courses) out of five. These responses were not much faster or more improved than in previous reports, and a dose of 6 million units may be too large to treat some ITP patients. The platelet-associated IgG level showed a tendency to be reduced with IFN therapy. The mechanism for the increase of the platelet count may be the modification of platelet autoantibody production.

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“…On the one hand, elevated levels of endogenous IFN-a were found in clinically active rheumatoid arthritis, scleroder ma, Sjogren's syndrome and lupus [28]; IFN therapy was reported to be associated with the development of au toimmune disorders such as lupus and thrombocytopenic purpura [23,24,29]. On the other hand, IFN-a was found to be efficient in the treatment of immune thrombocyto penia and in subacute cutaneous SLE [30,31]. Here we also have to remember the opposite effects of interferon on delayed hypersensitivity.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Dysfunctions in Hematologic Malignancies Treated with Alpha-lnterferon

Cavanna

Bertè

Merli³

et al. 1995

Acta Haematol

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The widespread use of alpha-interferon (IFN-α) therapy in different diseases draws attention to its side effects, such as autoimmune-related diseases, especially thyroid autoimmune dysfunctions. Data about hepatitis and nonhematologic neoplasia are available, while data about hematologic malignancies are fragmentary. We studied the incidence of autoimmune-related disturbances and thyroid dysfunctions in 54 consecutive patients suffering from hematologic malignancies, treated with recombinant human IFN-α for a mean time of 15.9 ± 8.9 months. Our results minimize the incidence of autoimmune dysfunctions in hematologic malignancies as side effects of IFN-α therapy. We registered the appearance of autoantibodies in only 3 females (5% of total): 2 patients (1 affected with essential thrombocythemia and one with multiple myeloma) presented antithyroglobulin antibodies with no clinical symptoms; 1 patient, affected with essential thrombocythemia, developed antinuclear antibodies with arthralgia and myalgia. ARA criteria for systemic lupus erythematosus were not fulfilled but the therapy had to be interrupted. No patient developed thyroid dysfunction. In patients with hematologic malignancies, the dosage and the duration of IFN-α treatment do not seem to influence the appearance of autoantibodies, while female sex appears to be a risk factor.

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Short-Course Alpha-Interferon Therapy in Severe Unresponsive Immune Thrombocytopenic Purpura

Cited by 36 publications

References 2 publications

Antibodies to platelet glycoproteins in haemophiliacs infected with HIV

Antibodies to platelet glycoproteins in haemophiliacs infected with HIV

Effect of Interferon(IFN) on Refractory Idiopathic Thrombocytopenic Purpura: Administration of 6 Million Units of Recombinant IFN alpha-2b.

Autoimmune Thyroid Dysfunctions in Hematologic Malignancies Treated with Alpha-lnterferon

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