Bessman D
Am J Hematol. 1982 Nov;13(3):219-27. doi: 10.1002/ajh.2830130305.
Mean megakaryocyte ploidy, mean platelet volume, and platelet count were measured during 17 courses of chemotherapy for acute nonlymphocytic leukemia. During the myelosuppression from chemotherapy, all three variables fell; during recovery, megakaryocyte ploidy rose 1-2 days before platelet volume, which in turn rose 1-2 days before platelet count. Serial platelet volumes and counts of these patients were compared to the nomogram of the inverse nonlinear relation between platelet count and platelet size in reference subjects. Platelet volume became inappropriately small before platelet count fell substantially and remained small through most of the thrombocytopenic nadir. The end of the nadir was predictable 1-2 days after platelet volume increased to lie congruent with the reference nomogram. Changes in thrombopoiesis appear to occur sequentially in megakaryocyte ploidy, platelet volume, and platelet count. Changes in platelet count, and therefore the appearance of duration of the thrombocytopenic nadir, can be predicted by 1-2 days with platelet volume and 3-4 days with megakaryocyte ploidy. As platelet count rose, despite the continuing predominance of "young" platelets, MPV fell, suggesting that megakaryocyte stimulation as well as platelet age affects platelet size.
在17个急性非淋巴细胞白血病化疗疗程中，对平均巨核细胞倍性、平均血小板体积和血小板计数进行了测量。在化疗引起的骨髓抑制期间，这三个变量均下降；在恢复期间，巨核细胞倍性在血小板体积升高前1 - 2天升高，而血小板体积又在血小板计数升高前1 - 2天升高。将这些患者的系列血小板体积和计数与参考对象中血小板计数和血小板大小之间的反向非线性关系列线图进行比较。在血小板计数大幅下降之前，血小板体积变得过小，并在大部分血小板减少最低点期间一直保持较小。最低点结束时间在血小板体积增加至与参考列线图一致后1 - 2天是可预测的。血小板生成的变化似乎依次发生在巨核细胞倍性、血小板体积和血小板计数方面。血小板计数的变化以及血小板减少最低点的持续时间可通过血小板体积提前1 - 2天和巨核细胞倍性提前3 - 4天进行预测。随着血小板计数上升，尽管“年轻”血小板仍占主导，但平均血小板体积下降，这表明巨核细胞刺激以及血小板年龄都会影响血小板大小。
