PMID- 7964946
OWN - NLM
STAT- MEDLINE
DCOM- 19941202
LR  - 20220321
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 12
IP  - 11
DP  - 1994 Nov
TI  - Clinical impact of chemotherapy-induced thrombocytopenia in patients with 
      gynecologic cancer.
PG  - 2317-20
AB  - PURPOSE AND METHODS: This retrospective analysis of 501 patients with gynecologic 
      cancer treated with chemotherapy evaluates the relationship between platelet 
      count and clinical bleeding, as well as the clinical effects of platelet 
      transfusion therapy. Thrombocytopenic patients were divided into six groups 
      according to platelet counts, and major or minor bleeding manifestations were 
      documented. Thrombocytopenia was defined as a platelet count less than 
      100,000/microL. RESULTS: Thrombocytopenia occurred in 182 (36.3%) patients over 
      808 of 1,546 chemotherapy cycles (52%). No intracranial or life-threatening 
      bleeding occurred in any patient. The majority of patients (139 [76.4%]) had no 
      clinical bleeding. Minor bleeding, such as purpura, occurred in 34 patients 
      (18.7%) and 44 cycles (5.4%). Major bleeding occurred in nine patients (4.9%) and 
      10 cycles (1.3%). Five major bleeding events occurred in 49 patients with 
      platelet counts between 0 and 10,000/microL. Forty-three of these patients 
      received platelet transfusions. Thirty-eight of 43 transfused patients (88.3%) 
      had no bleeding. Of the remaining five patients, two were transfused 
      prophylactically with no effect. Three major bleeding events occurred in patients 
      with platelet counts that ranged from 11,000 to 20,000/microL, but these were due 
      to chronic instrumentation or trauma. In patients with platelet counts more than 
      20,000/microL, major bleeding occurred only from necrotic metastatic lesions. 
      Random-donor platelet transfusions provided inconsistent increments in platelet 
      counts. Overall, 27.5% of patients achieved the expected increase in platelet 
      number based on units of platelet concentrate transfused. The use of single-donor 
      or human leukocyte antigen (HLA)-matched platelets did not provide greater 
      increments in those patients who were refractory to random-donor platelets. 
      CONCLUSION: Platelet counts > or = 10,000/microL are not associated with 
      spontaneous major bleeding. Prophylactic platelet transfusions in patients with 
      gynecologic malignancies and chemotherapy-induced thrombocytopenia should be 
      limited to those with platelet counts < or = 10,000/microL, provided they are not 
      bleeding and have no major anatomic or pathophysiologic precursors of bleeding.
FAU - Goldberg, G L
AU  - Goldberg GL
AD  - Department of Obstetrics and Gynecology, Albert Einstein College of 
      Medicine/Montefiore Medical Center, Bronx, NY 10461.
FAU - Gibbon, D G
AU  - Gibbon DG
FAU - Smith, H O
AU  - Smith HO
FAU - DeVictoria, C
AU  - DeVictoria C
FAU - Runowicz, C D
AU  - Runowicz CD
FAU - Burns, E R
AU  - Burns ER
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/*adverse effects
MH  - Female
MH  - Hemorrhage/chemically induced/complications
MH  - Humans
MH  - Ovarian Neoplasms/complications/*drug therapy
MH  - Platelet Count
MH  - *Platelet Transfusion
MH  - Retrospective Studies
MH  - Thrombocytopenia/*chemically induced/classification/complications/therapy
MH  - Uterine Neoplasms/*drug therapy
MH  - Vaginal Neoplasms/complications/*drug therapy
EDAT- 1994/11/01 00:00
MHDA- 1994/11/01 00:01
CRDT- 1994/11/01 00:00
PHST- 1994/11/01 00:00 [pubmed]
PHST- 1994/11/01 00:01 [medline]
PHST- 1994/11/01 00:00 [entrez]
AID - 10.1200/JCO.1994.12.11.2317 [doi]
PST - ppublish
SO  - J Clin Oncol. 1994 Nov;12(11):2317-20. doi: 10.1200/JCO.1994.12.11.2317.