Mechanisms of thrombocytopenia in patients with lymphoproliferative diseases

• Published in: European journal of haematology Vol. 49; no. 3; p. 113
• Main Authors: Kuznetsov, A I, Ivanov, A L, Idelson, L I, Mazurov, A V
• Format: Journal Article
• Language: English
• Published: England 01.09.1992
• Subjects: Antibodies - analysis; Blood Platelets - immunology; Blood Platelets - metabolism; Bone Marrow - pathology; Cell Count; Humans; Immunoglobulin G - metabolism; Leukemia, Hairy Cell - complications; Leukemia, Hairy Cell - immunology; Leukemia, Hairy Cell - pathology; Leukemia, Lymphocytic, Chronic, B-Cell - complications; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Megakaryocytes - pathology; Platelet Count; Thrombocytopenia - blood; Thrombocytopenia - etiology
• ISSN: 0902-4441
• DOI: 10.1111/j.1600-0609.1992.tb00913.x

Different factors are involved in the development of thrombocytopenia in patients with lymphoproliferative disorders. Significant correlation was detected between the number of megakaryocytes in bone marrow and platelet count (r = 0.485, p = 0.002, n = 37) and significant difference between the number of megakaryocyte in patients with normal platelet count (> 200,000/microliters) and patients with marked thrombocytopenia (platelet count < 100,000/microliters). All patients in the latter group (n = 15) had a relatively low number of megakaryocytes. Low but significant reverse correlation was found between the level of platelet-associated IgG (PA-IgG) and platelet count (r = -0.249, p = 0.024, n = 82) and significant difference between the mean levels of PA-IgG in the groups of patients with platelet count > 200,000/microliters and < 100,000/microliters. PA-IgG were increased in 46% of patients in the total group and in 65% of patients with platelet count < 100,000/microliters. The correlation between platelet count and PA-IgG was about 2 times higher in splenectomized (r = -0.549, p = 0.005, n = 24) than nonsplenectomized patients. All splenectomized patients with platelet count < 100,000/microliters (n = 8) had a significant increase in PA-IgG. Serum antibodies were detected in only 7% of tested patients. This group was characterized by severe thrombocytopenia (in 6 of 10 patients--platelet count < 50,000/microliters) and a high incidence of haemorrhages (in 5 of 10 patients). Thus the depression of platelet production was suggested to be the basic cause of thrombocytopenia in lymphoproliferative disorders. Involvement of immune mechanisms was revealed in a large number of patients and correlated with a deeper and more complicated thrombocytopenia.