Abstract
Association of severe thrombocytopenia related to increased destruction of platelets and administration of AMD has recently been reported (J Pediatr 104:611, 1985). To investigate the etiology of this phenomenon, we reviewed the clinical and laboratory status of 40 pediatric patients with solid tumors. Twenty-eitht of the 40 patients received AMD as part of their treatment. The presence of PAIg was determined by a previously described ELISA technique (Transfusion 24:348, 1984). Eight of the 28 patients receiveing AMD demonstrated thrombocytopenia associated with increased destruction and not myelosuppression by these criteria: a) documentation of thrombocytopenia less than 7 days after administration of AMD without the concomitant depression of other cell lines and b) no evidence of disseminated intravascular coagulation or other non-specific consumption. The median platelet count for thrombocytopenic patients was 80,000/ul (range 13,000-149,000). Thrombocytopenia associated with peripheral destruction did not develop in any of 12 patients not receiving AMD, Six of 8 thrombocytopenic patients on AMD had evidence of PAIg, while 9 of 19 non-thrombocytopenic AMD patients demonstrated PAIg. Also, 5 of 10 patients not receiving AMD had evidence of PAIg. Although thrombocytopenia associated with increased destruction was seen in nearly a third of patients receiving AMD, this phenomenon could not be associated with an increase in PAIg.
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Paul, S., Cusack, N., James, K. et al. THROMBOCYTOPENIA AND PLATELET ASSOCIATED IMMUNOGLOBULIN (PAIg) IN PATIENTS RECEIVING ACTINOMYCIN D. (AMD). Pediatr Res 21 (Suppl 4), 304 (1987). https://doi.org/10.1203/00006450-198704010-00822
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DOI: https://doi.org/10.1203/00006450-198704010-00822