IMMUNE THROMBOCYTOPENIA IN PATIENTS WITH SOLID TUMORS: AN UPDATE (MEETING ABSTRACT)

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

IMMUNE THROMBOCYTOPENIA IN PATIENTS WITH SOLID TUMORS: AN UPDATE (MEETING ABSTRACT)

Proc Annu Meet Am Soc Clin Oncol; 10:A1173 1991. Unique Identifier : AIDSLINE ICDB/91672510
Silberberg JM; Zarrabi MH; VAMC, Northport, NY 11768

Abstract: We have previously reported (ASCO 7:286, 1988) our experience with patients (pts) with immune thrombocytopenia (IT) and solid tumors (S). This association is not rare and we have now seen 7 such cases. The criteria for this syndrome include pts with platelet (P) counts less than 110K in the absence of extensive bone marrow (BM) invasions by S, decreased megakaryocytes or evidence of DIC, HUS, etc. Specifically excluded are pts receiving biologics, BM transplants, act D, or recent blood transfusions or with HIV infections. Including our cases, at least 72 such cases have been reported. Analysis of these 72 cases shows: mean age 59.2 yr (r 1.1-84); male:female 1; 70 malignant, 2 benign. Tumor types include GU/Gyn (18), lung (13 NSCLC, 2 SCLC), GI (13), breast (6), germ cell (4 mediast, 2 testes), H and N (4), skin (2 melanoma, 1 basal cell), non-AIDS Kaposi's (2). When studied, mean nadir P count was 22,320 (less than 1-101K) and mean P survival 2.4 days (r 0.15-7.5). Immunologic studies included P associated IgG and/or IgM, or serum abs (35 elevated, 9 nl); ANA (6 positive [pos], 14 negative [neg]); immune complexes (2 pos); Direct Coombs (3 pos, 10 neg). Bone marrow was involved with S in 7, negative in 29. Response to therapy of IT: corticosteroids--32 responders (R), 14 nonresponders (N); splenectomy--11R, 7N; vincristine--4R, 3N; iv IgG--3R, 1N; plasmapheresis--2R, 2N; interferon--1R. IT was diagnosed simultaneously with S in 35, before in 6, and after in 19. At last report, 35 pts were alive (17 with disease, 10 without disease, 8 not stated), 22 dead. The incidence of IT in S at our institution is approx 0.01%. The association of IT with S is uncommon but not rare. Possible hypotheses for this association will be reviewed.

Keywords: Antigen-Antibody Complex/ANALYSIS Female Human IgG/ANALYSIS Male Megakaryocytes/IMMUNOLOGY Middle Age Neoplasm Invasiveness Neoplasms/BLOOD/*IMMUNOLOGY/PATHOLOGY Platelet Count Syndrome Thrombocytopenia/BLOOD/*ETIOLOGY/IMMUNOLOGY ABSTRACT
911030
M91A1122

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