Abstract
We studied five pediatric solid tumor patients (age 13-72 mo.),(3 Wilms and 2 Rhabdomyosarcomas) treated with Vincristine and ACT-D (15 mcg/kg × 5 days) with or without Cyclophosphamide or Adriamycin. All five patients developed significant early thrombocytopenia (TCP) while on VAC.
There was no significant difference in Absolute Granulocyte Count on day 5 in VAC vs VDRC treatment, 3006±1607/UL vs 3173±1728/UL, P-NS. Lowering the dose (25%) did not decrease the incidence or severity of the TCP. All patients who developed significant TCP while on VAC therapy had BMA revealing markedly increased megakaryocytes suggesting a drug induced peripheral destructive process. All 5 patients were treated with fresh plts (1 U/10 lbs) without a significant rise in their plt count. Therefore, we pretreated 4 patients with Prednisone (2mg/kg/day) starting 2 days prior to VAC therapy for a total of 10 days. The total mean pit count was compared in the steroid treated vs the non-steroid treated group. All patients have remained in complete remission and have not had any steroid induced complications. Prednisone therapy given concurrently with VAC in pediatric patients with ACT-D induced TCP can decrease morbidity and eliminate life-threatening TCP.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hodder, F., Kempert, P., McCormack, S. et al. EARLY LIFE THREATENING THROMBOCYTOPENIA UNRELATED TO BONE MARROW SUPPRESSION SECONDARY TO ACTINOMYCIN-D (ACT-D) IN FIVE PEDIATRIC SOLID TUMOR PATIENTS SUCCESSFULLY TREATED WITH PREDNISONE THERAPY. Pediatr Res 18 (Suppl 4), 241 (1984). https://doi.org/10.1203/00006450-198404001-00889
Issue Date:
DOI: https://doi.org/10.1203/00006450-198404001-00889