Immune-mediated platelet destruction and thrombocytopenia in patients with solid tumours.

Autoimmune mediated platelet destruction with severe thrombocytopenia was documented in eight patients with solid tumours. The patients had reduced platelet lifespan, positive platelet antibody tests, increased numbers of megakaryocytes, and a rise in platelet count following treatment with steroids, splenectomy or immunosuppressive therapy. Intravascular coagulation was excluded as the predominant cause of thrombocytopenia by near normal 125I-fibrinogen survival; thrombocytopenia secondary to marrow suppression was ruled out by increased platelet turnover. Thus, like patients with lymphoproliferative disorders, patients with solid tumours may be thrombocytopenic because of immune mediated platelet destruction.