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Platelet kinetics in patients with bone marrow hypoplasia: evidence for a
fixed platelet requirement
SR Hanson and SJ Slichter
We have studied 16 normal subjects and 27 patients with stable, untreated
thrombocytopenia secondary to bone marrow failure and platelet counts
ranging from 12,000 to 70,000/microL. Autologous platelets were labeled
with 51Cr for measurement of mean platelet life span in the normal subjects
and in 20 patients. Labeled donor cells were used in the remaining
subjects. Platelet survival, as determined with both autologous and
homologous platelets, correlated directly with platelet count in the
thrombocytopenic patients. Platelet life span was only modestly reduced in
patients having counts in the range of 50,000 to 100,000/microL (7.0 +/-
1.5 days v 9.6 +/- 0.6; P less than .01) but was markedly reduced when the
count fell below 50,000/microL (5.1 +/- 1.9 days, P less than .001). The
recovery of donor platelets in severely thrombocytopenic recipients (60%
+/- 15%) was equivalent to control values (66% +/- 8%; P greater than .2).
The recovery of autologous platelets was normal when the platelet count
exceeded 50,000/microL (74% +/- 15%) but was reduced in patients with lower
counts (50% +/- 22%; P less than .01). All patient and normal data were
well correlated by a model predicting a maximum platelet life span of 10
1/2 days and a fixed requirement for 7,100 platelets per microliter of
blood per day, or about 18% of the normal rate of platelet turnover, which
averaged 41,200 platelets per microliter per day. We conclude that although
relatively few platelets are used to support vascular integrity, this
requirement is reflected by a reduced platelet life span in marrow
hypoplasia and may contribute to the shortening of platelet survival
observed in other thrombocytopenias.
Volume 66,
Issue 5,
pp. 1105-1109,
11/01/1985
Copyright © 1985 by The American Society of Hematology
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