Durand Pauline, Pottier Valérie, Mesguich Charles, Debordeaux Frédéric, Lazaro Estibaliz, Viallard Jean-François, Rivière Etienne
Department of Internal Medicine and Infectious Diseases, Haut-Leveque Hospital, University Hospital Centre of Bordeaux, 33600, Pessac, France.
Radiopharmacy Department, University Hospital Centre of Bordeaux, Pessac, France.
Exp Hematol Oncol. 2023 May 30;12(1):50. doi: 10.1186/s40164-023-00414-1.
Thrombocytopenia occurs in 60% of patients with myelodysplastic syndromes (MDS), increasing the risk of life-threatening haemorrhage in this population of mainly old patients with comorbidities. However, data are scare regarding immune thrombocytopenia (ITP) secondary to MDS.
We analyzed the utility of indium-111 platelet scintigraphy (IPS) to better characterize the mechanisms of thrombocytopenia in 21 adult patients with MDS.
Adult patients with a definite diagnosis of MDS according to the international criteria who underwent IPS between 2009 and 2018 because of an increased bleeding risk were retrospectively selected. Autologous 111Indium platelet labelling was performed with a technique similar to that described previously using a standardized method.
Platelet lifespan ≤ 6 days identified patients with peripheral platelet destruction. Taking into account the response to ITP-directed therapies after IPS, the sensitivity, specificity, and positive and negative predictive values of IPS were 100%, 84.6%, 80%, and 100%, respectively.
We show that IPS can be a useful tool to identify the mechanism and guide treatment of a chronic thrombocytopenia increasing the bleeding risk in patients with MDS.
骨髓增生异常综合征（MDS）患者中60%会出现血小板减少，这增加了这群主要为老年合并症患者危及生命的出血风险。然而，关于MDS继发免疫性血小板减少症（ITP）的数据却很匮乏。
我们分析了铟-111血小板闪烁显像（IPS）在更好地明确21例成年MDS患者血小板减少机制方面的作用。
回顾性选取2009年至2018年间因出血风险增加而接受IPS检查、根据国际标准确诊为MDS的成年患者。采用与之前描述的类似技术，通过标准化方法进行自体铟-111血小板标记。
血小板生存期≤6天可识别外周血小板破坏的患者。考虑IPS检查后对ITP针对性治疗的反应，IPS的敏感性、特异性、阳性预测值和阴性预测值分别为100%、84.6%、80%和100%。
我们表明，IPS可作为一种有用的工具，用于识别MDS患者慢性血小板减少症增加出血风险的机制并指导治疗。
