Patients with chronic ITP
. | Splenectomy Response . | Anti-GPIIb/IIIa* . | . | Anti-GPIb/IX* . | . | . | ||
|---|---|---|---|---|---|---|---|---|
| Patient . | . | Plt-assoc . | Plasma . | Plt-assoc . | Plasma . | Medications . | ||
| ITP-1 | NR | 313.9 | 52 | 134.5 | 22.0 | IgG | ||
| ITP-2† | NR | ND | ND | ND | ND | SM | ||
| ITP-3 | NR | 194.8 | 28.0 | Neg | ND | Pred | ||
| ITP-4 | NR | 1210.8 | 287.0 | Neg | ND | Pred | ||
| ITP-5† | NR | 1109.0 | 53.0 | Neg | ND | Az, Dn, Pred | ||
| ITP-6† | NR | Neg | ND | 226.7 | 128.0 | None | ||
| ITP-7 | NR | 10.8 | Neg | 518.5 | 112.0 | Pred | ||
| ITP-8† | NR | 35.9 | 10.0 | 40.4 | 13.0 | None | ||
| ITP-9 | NR | 163.0 | 152.0 | Neg | ND | Pred | ||
| ITP-10 | NR | 104.1 | 24.0 | Neg | ND | None | ||
| ITP-11 | NR | 28.8 | Neg | 135.6 | 113.0 | Pred | ||
| ITP-12 | NR | 228.0 | 8.0 | 5.6 | ND | CSA, Pred | ||
| ITP-13 | CR | 347.1 | 53.0 | 10.4 | ND | Pred | ||
| ITP-14 | NR | 1310.0 | 130.0 | 13.0 | 13.0 | IgG | ||
| ITP-15† | NR | 24.3 | Neg | 415.5 | 18.0 | Vinc | ||
| ITP-16 | PR | 21.0 | Neg | 29.3 | 120.0 | Pred | ||
| ITP-17† | NR | 182.9 | 41.0 | 21.1 | Neg | SM | ||
| ITP-18 | NR | 80.8 | 79.0 | Neg | Neg | Az, Pred | ||
. | Splenectomy Response . | Anti-GPIIb/IIIa* . | . | Anti-GPIb/IX* . | . | . | ||
|---|---|---|---|---|---|---|---|---|
| Patient . | . | Plt-assoc . | Plasma . | Plt-assoc . | Plasma . | Medications . | ||
| ITP-1 | NR | 313.9 | 52 | 134.5 | 22.0 | IgG | ||
| ITP-2† | NR | ND | ND | ND | ND | SM | ||
| ITP-3 | NR | 194.8 | 28.0 | Neg | ND | Pred | ||
| ITP-4 | NR | 1210.8 | 287.0 | Neg | ND | Pred | ||
| ITP-5† | NR | 1109.0 | 53.0 | Neg | ND | Az, Dn, Pred | ||
| ITP-6† | NR | Neg | ND | 226.7 | 128.0 | None | ||
| ITP-7 | NR | 10.8 | Neg | 518.5 | 112.0 | Pred | ||
| ITP-8† | NR | 35.9 | 10.0 | 40.4 | 13.0 | None | ||
| ITP-9 | NR | 163.0 | 152.0 | Neg | ND | Pred | ||
| ITP-10 | NR | 104.1 | 24.0 | Neg | ND | None | ||
| ITP-11 | NR | 28.8 | Neg | 135.6 | 113.0 | Pred | ||
| ITP-12 | NR | 228.0 | 8.0 | 5.6 | ND | CSA, Pred | ||
| ITP-13 | CR | 347.1 | 53.0 | 10.4 | ND | Pred | ||
| ITP-14 | NR | 1310.0 | 130.0 | 13.0 | 13.0 | IgG | ||
| ITP-15† | NR | 24.3 | Neg | 415.5 | 18.0 | Vinc | ||
| ITP-16 | PR | 21.0 | Neg | 29.3 | 120.0 | Pred | ||
| ITP-17† | NR | 182.9 | 41.0 | 21.1 | Neg | SM | ||
| ITP-18 | NR | 80.8 | 79.0 | Neg | Neg | Az, Pred | ||
Plasma of patients ITP-1 through ITP-12 suppressed in vitro megakaryocyte production; plasma of patients ITP-13 through ITP-18 did not. Plt-assoc, platelet-associated; NR, no response; ND, not done; CR, complete remission; SM, methylprednisolone (Solu-Medrol); Neg, negative; Pred, prednisone; Az, azathioprine; Dn, danazol; IgG, intravenous gamma globulin; CSA, cyclosporine; and Vinc, vincristine.
Polystyrene beads, coated with monoclonal anti-GPIIb or anti-GPIb and blocked with BSA, were incubated with washed, solubilized patient platelets (108) or with normal platelets (108) that had been incubated with 1.0 mL patient plasma, followed by washing and solubilization. After incubation and washing, bound autoantibody-GP immune complexes were detected with radiolabeled monoclonal antihuman IgG. Results are expressed as a ratio of cpm patient sample/mean cpm of 3 control samples. A ratio of more than 3.0 is considered positive.
Patient died of disease.