Thromocytopenia in malignancy. Introduction into the topic: causes, prognostic and therapeutic implications

Czech version

Authors: E. Faber
Authors‘ workplace: Hemato-onkologická klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Karel Indrák, DrSc.
Published in: Vnitř Lék 2010; 56(Supplementum 1): 27-30
Category: 16th Parizek's Days, Ostrava-Poruba, March 25th –26th 2010

Overview

Incidence of thrombocytopenia in malignancy markedly differ according its pathogenesis. Clinical importance of thrombocytopenia including development of serious bleeding is not directly associated with the number of platelets but frequently with other circumstances or complications. Prognosis of patients with thrombocytopenia caused by marrow metastatic infiltration, disseminated coagulopathy or microangiopathy is generally very serious. The treatment of thrombocytopenia in malignancy should be aimed towards elimination of its cause.

Key words:
thrombocytopenia – cancer – prognosis

Sources

1. Warketin TE, Kelton JG. Thrombocytopenia due to platelet destruction and hypersplenism. In: Hoffman R, Benz Jr EJ, Shattil SJ et al. Hematology basic principles and practice 4th Edition. Philadelphia: Elsevier Churchill Livingstone 2005: 2305– 2325.

2. Aster RH. Pooling of platelets in the spleen: Role in the pathogenesis of „hypersplenic“ thrombocytopenia. J Clin Invest 1966; 45: 645– 657.

3. Belt RJ, Leite C, Haas CD et al. Incidence of hemorrhagic complications in patients with cancer. J Am Med Assoc 1978; 239: 2571– 2574.

4. Dutcher JP, Schiffer CA, Aisner J et al. Incidence of thrombocytopenia and serious hemorrhage among patients with solid tumors. Cancer 1984; 53: 557– 562.

5. Goldberg GL, Gibbon DG, Smith HO et al. Clinical impact of chemotherapy-induced thrombocytopenia in patients with gynecolocig cancer. J Clin Oncol 1994; 12: 2317– 2320.

6. Avvisati G, Tirindelli MC, Annibali O. Thrombocytopenia and hemorrhagic risk in cancer patients. Crit Rew Oncol Hematol 2003; 48S: S13– S16.

7. Medina PJ, Sipols JM, George JN. Drug-associated thrombotic thrombocytopenic purpura – hemolytic uremic syndrome. Curr Opin Hematol 2001; 8: 286– 293.

8. Sallah S, Wan J, Nguyen N et al. Disseminated intravascular coagulation in solid tumors: clinical and pathologic study. Thromb Haemost 2001; 86: 828– 833.

9. Forman RB, Benkel SA, Novik Y et al. Presence of ADAMTS13 activity in a patient with metastatic cancer and thrombotic microangiopathy. Acta Hematol 2003; 109: 150– 152.

10. Cervantes F, Pereira A, Esteve J et al. Identification of “short-lived” and “long-lived” patients at presentation of idiopathic myelofibrosis. Br J Haematol 1997; 97: 635– 640.

11. Hasselbalch H, Jensen BA. Prognostic factors in idiopathic myelofibrosis: a simple scoring system with prognostic significance. Eur J Haematol 1990; 44: 172– 178.

12. Sokal JE, Cox EB, Baccarani M et al. Prognostic discrimination in “good- risk” chronic granulocytic leukemia. Blood 1984; 63: 789– 799.

13. Hasford J, Pfirrmann M, Hehlmann R et al. A new prognostic score for survival of patients with chronic myeloid leukemia treated with interferon alfa. J Natl Canc Inst 1998; 90: 850– 858.

14. Hubáček J, Faber E, Slezák P et al. Mikroangiopatická hemolytická anemie jako první projev metastazujícího karcinomu. Prakt Lék 1996; 76: 555– 558.

15. Tomšová M, Žák P. Mikroangiopatická hemolytická anémie s trombocytopenií (cr- TTP) u pacienta s generalizovaným adenokarcinomem žaludku. Čs Patol 2003; 39: 26– 30.

16. Lesesne JB, Rothschild N, Erickson B et al. Cancer-associated hemolytic uremic syndrome. Analysis of 85 cases from a national registry. J Clin Oncol 1989; 7: 781– 789.

17. von Baeyer H. Plasmapheresis in thrombotic microangiopathy-associated syndromes: Review of of outcome data derived from clinical trials and open studies. Ther Apheresis 2002; 6: 320– 328.

18. Isaacs C, Robert NJ, Bailey FA et al. Randomized placebo- controlled study of recombinant human interleukin-11 to prevent chemotherapy-induced thrombocytopenia in patients with breast cancer receiving dose-intensive cyclophosphamide and doxorubicin. J Clin Oncol 1997; 15: 3368– 3377.

19. Tepler I, Elias L, Smith II et al. A randomized placebo- controlled trial of recombinant human interleukin-11 in cancer patients with severe thrombocytopenia due to chemotherapy. Blood 1996; 87: 3607– 3614.

20. Aribi A, Kantarjian H, Koller C et al. Effect of interleukin 11 on thrombocytopenia associated with tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia. Cancer 2008; 113: 1338– 1343.