Catani L, Vianelli N, Luatti S, Rizzi S, Castellani S, Valdrè L, Lemoli R M, Tura S
Hematology and Medical Oncology Institute LA Seràgnoli, University of Bologna, Italy.
Bone Marrow Transplant. 1999 Dec;24(11):1191-4. doi: 10.1038/sj.bmt.1702062.
Thrombocytopoiesis of 21 multiple myeloma patients undergoing single or double transplant regimen was characterized by measuring the level of reticulated platelets and plasma glycocalicin. Since reticulated platelets are an index of thrombopoietic activity and glycocalicin plasma values are related to platelet damage and turnover, it may be possible to perform a novel type of analysis of the thrombopoietic compartment during the mobilizing regimen and during transplant-related chemotherapy. Patients underwent mobilizing therapy and first transplant. Some randomized patients also underwent a second transplant with mobilized peripheral blood stem cells. The results show that the percentage of reticulated platelets decreased after therapy and then gradually increased in the recovery phase either during first or second transplant. By contrast, the percentage of reticulated platelets increased until day +8 and then gradually decreased during the mobilizing regimen. The glycocalicin index (glycocalicin plasma value normalized for the individual platelet count) increased significantly both during the course of mobilization and after transplant-related chemotherapy when the platelet number was at its nadir. However, the glycocalicin index was more elevated after transplant-related chemotherapy than after the mobilizing regimen. Our findings suggest that chemotherapy-related thrombocytopenia may be due to a dual mechanism: thrombocytopenia results from decreased platelet production in addition to increased platelet damage and possible destruction.
通过测量网织血小板水平和血浆糖萼蛋白，对21例接受单移植或双移植方案的多发性骨髓瘤患者的血小板生成情况进行了表征。由于网织血小板是血小板生成活性的指标，而血浆糖萼蛋白值与血小板损伤和更新有关，因此在动员方案期间和移植相关化疗期间，有可能对血小板生成区室进行一种新型分析。患者接受了动员治疗和首次移植。一些随机分组的患者还接受了动员外周血干细胞的第二次移植。结果显示，治疗后网织血小板百分比下降，然后在首次或第二次移植的恢复阶段逐渐增加。相比之下，在动员方案期间，网织血小板百分比一直增加到第8天，然后逐渐下降。当血小板数量处于最低点时，血浆糖萼蛋白指数（根据个体血小板计数进行标准化的血浆糖萼蛋白值）在动员过程中和移植相关化疗后均显著升高。然而，移植相关化疗后的血浆糖萼蛋白指数比动员方案后的更高。我们的研究结果表明，化疗相关的血小板减少可能是由于双重机制：血小板减少除了血小板损伤增加和可能的破坏外，还源于血小板生成减少。
