Prospective screening of 205 patients with ITP, including diagnosis, serological markers, and the relationship between platelet counts, endogenous thrombopoietin, and circulating antithrombopoietin antibodies

被引:147
作者
Aledort, LM
Hayward, CPM
Chen, MG
Nichol, JL
Bussel, J
机构
[1] Mt Sinai Hosp, Dept Med, New York, NY 10029 USA
[2] McMaster Univ, Med Ctr, Dept Pathol, Hamilton, ON L8N 3Z5, Canada
[3] McMaster Univ, Med Ctr, Dept Mol Med, Hamilton, ON L8N 3Z5, Canada
[4] McMaster Univ, Med Ctr, Dept Med, Hamilton, ON L8N 3Z5, Canada
[5] Amgen Inc, Biostat, Thousand Oaks, CA 91320 USA
[6] Amgen Inc, Oncol Therapeut Dev, Thousand Oaks, CA 91320 USA
[7] New York Presbyterian Hosp, Dept Pediat, New York, NY USA
关键词
antibody formation; megalkaryocytes; therapeutics; thrombosis; thrombocytopenia;
D O I
10.1002/ajh.20104
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Immune thrombocytopenia purpura (ITP) is characterized by destruction of circulating platelets and the presence of antiplatelet antibodies. Many of the current immunomodulatory therapies act by reducing platelet destruction and usually do not have a lasting effect. This prospective, exploratory study characterized patients with ITP by identifying their demographic and comorbid clinical factors, use of treatments, serologic markers of autoimmunity, and possible relationships between platelet counts, concentrations of endogenous thrombopoietin (eTPO), and the presence of circulating anti-TPO antibodies. Data including medical history and laboratory evaluations were collected at a single patient visit on 205 patients (19 children, 186 adults). Reported histories revealed a 5% rate of thrombotic/ischemic events. Autoimmune markers including direct antiglobulin test and antinuclear antibodies were found more frequently than in the normal population; antiplatelet antibody testing was not done. eTPO concentrations were comparable to concentrations found in healthy volunteers. Our study confirmed that no significant inverse correlation occurred between circulating concentrations of eTPO and platelet counts in patients with ITP (Spearman r = -0.15). Two of the 205 patients tested (1%) had neutralizing activity of recombinant human TPO in a biological assay; however, this activity was confirmed to be anti-TPO antibody in only 1 patient. (C) 2004 Wiley-Liss, Inc.
引用
收藏
页码:205 / 213
页数:9
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