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Platelet kinetics in patients with idiopathic thrombocytopenic purpura and
moderate thrombocytopenia
D Stoll, DB Cines, RH Aster and S Murphy
We studied ten normal subjects and 20 patients with stable, untreated
idiopathic thrombocytopenic purpura (ITP) and platelet counts in the range
of 35,000 to 110,000/microL. The diagnosis was made by clinical criteria.
Platelet-associated IgG was increased in all nine of the nine patients
studied. Autologous platelets were labeled with chromium 51 and reinfused
for measurement of mean cell life and platelet production rate. Mean cell
life was calculated by two methods, weighted mean and multiple hit, with
excellent agreement between the two. As expected, mean cell life was
significantly reduced in ITP patients as compared to the normal subjects
(2.9 days v. 8.0 days, P less than .001). However, mean platelet production
rates in ITP patients and normal subjects, 3.5 and 3.8 X 10(9)
platelets/k/d respectively, were not significantly different. Platelet
production rate was above and below the normal range (2 to 5.6 X 10(9)
platelets/k/d) in two and four patients, respectively. We conclude that the
rate of platelet production is not increased in most patients with ITP who
have platelet counts greater than 35,000/microL. We did find that platelet
size was increased in eight of the 12 patients in whom it was measured,
including two of the patients with low platelet production.
Volume 65,
Issue 3,
pp. 584-588,
03/01/1985
Copyright © 1985 by The American Society of Hematology
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