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Roeser A, Moulis G, Ebbo M, Terriou L, Poullot E, Lioger B, Chilles M, Labussière-Wallet H, Mausservey C, Pha M, Puyade M, Cheze S, Limal N, Michel M, Godeau B, Mahévas M. Characteristics, management and outcome of acquired amegakaryocytic thrombocytopenia. Br J Haematol 2022; 198:595-599. [PMID: 35538740 DOI: 10.1111/bjh.18235] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Anais Roeser
- Service de Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de l'adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Guillaume Moulis
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; CIC 1436, équipe PEPSS, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,CIC 1436, équipe PEPSS, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Mikael Ebbo
- Service de Médecine Interne, Hôpital La Timone, CHU Marseille, Aix-Marseille Université, Marseille, France
| | - Louis Terriou
- Service de Médecine Interne et Immunologie Clinique, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Elsa Poullot
- Service d'anatomopathologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Bertrand Lioger
- Service de Médecine Interne, Hôpital Simone Veil, Blois, France
| | - Marie Chilles
- Service de Médecine Interne, Centre Hospitalier Régional d'Orléans, Orléans, France
| | - Helene Labussière-Wallet
- Service d'hématologie Clinique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | | | - Micheline Pha
- Service de médecine interne, Centre de référence du lupus, syndrome des anticorps antiphospholipides et autres maladies auto-immunes rares, Groupement Hospitalier Pitié-Salpêtrière (GHPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Mathieu Puyade
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Stephane Cheze
- Institut d'Hématologie de Basse-Normandie, Centre Hospitalier Universitaire de Caen Normandie, Caen, France
| | - Nicolas Limal
- Service de Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de l'adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Marc Michel
- Service de Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de l'adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Bertrand Godeau
- Service de Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de l'adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Matthieu Mahévas
- Service de Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de l'adulte, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
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Transient acquired amegakaryocytic thrombocytopenia associated with Pediatric Hodgkin Lymphoma: A case report. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Nishiwaki N, Kojima H, Isaka M, Bando E, Terashima M, Ohde Y. Pulmonary resection for metachronous metastatic gastric cancer diagnosed using multi-detector computed tomography: Report of five cases. Int J Surg Case Rep 2020; 73:342-346. [PMID: 32739523 PMCID: PMC7397694 DOI: 10.1016/j.ijscr.2020.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/04/2022] Open
Abstract
The standard treatment for metastatic gastric cancer is systemic chemotherapy. Pulmonary resection for metastatic gastric cancer has been rarely reported on. Five patients with metastatic gastric cancer diagnosed using MDCT underwent surgery. We demonstrated remarkably better survival values compared to previous reports. Pulmonary resection may be treatment option for select patients.
Introduction As pulmonary resection for metastatic gastric cancer has been rarely reported on, the role of metastasectomy remains unclear in such settings. We reviewed the clinicopathological characteristics and surgical outcomes of patients with metachronous pulmonary metastasis from gastric cancer (MPMGC) diagnosed using multi-detector computed tomography (MDCT) who underwent pulmonary resection. Presentation of case From September 2002 to May 2018, five patients underwent pulmonary resection for MPMGC at Shizuoka Cancer Center. All patients received curative resection for initial gastric cancer. Three patients received adjuvant chemotherapy. The median age at pulmonary resection was 70 years. The median disease-free interval between initial gastrectomy and MPMGC diagnosis was 41 months. The first site of recurrence was the lung in all patients. All patients were diagnosed as having primary lung cancer using MDCT before pulmonary resection and fit the surgical indication for primary lung cancer. Lobectomy was performed in three patients, while wedge resection was performed in two. The median overall survival following pulmonary resection was 79 (range, 18–89) months. Two patients experienced recurrence. While one showed recurrence in the mediastinal lymph node, in the other it was observed in the remnant lung; the latter underwent repeated pulmonary resection followed by systemic chemotherapy. Four patients survived for longer than 4 years after pulmonary resection. Conclusions Of the five patients with MPMGC diagnosed using MDCT who underwent pulmonary resection, long-term survival was achieved after pulmonary resection in four. Thus, pulmonary resection may be considered for those diagnosed with lung nodules after surgery for gastric cancer, and who fit the surgical indication for primary lung cancer.
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Affiliation(s)
- Noriyuki Nishiwaki
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan; Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Hideaki Kojima
- Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Mitsuhiro Isaka
- Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Etsuro Bando
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Masanori Terashima
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Yasuhisa Ohde
- Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
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Velo-García A, Castro SG, Isenberg DA. The diagnosis and management of the haematologic manifestations of lupus. J Autoimmun 2016; 74:139-160. [DOI: 10.1016/j.jaut.2016.07.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/01/2016] [Indexed: 12/21/2022]
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Witteles WH, Schrier SL, Wakelee HA. Lung Cancer Presenting With Amegakaryocytic Thrombocytopenia. J Clin Oncol 2008; 26:1171-4. [DOI: 10.1200/jco.2007.14.8106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Wesley H. Witteles
- Division of Hematology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA
| | - Stanley L. Schrier
- Division of Hematology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA
| | - Heather A. Wakelee
- Division of Oncology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA
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Agarwal N, Spahr JE, Werner TL, Newton DL, Rodgers GM. Acquired amegakaryocytic thrombocytopenic purpura. Am J Hematol 2006; 81:132-5. [PMID: 16432869 DOI: 10.1002/ajh.20510] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Acquired amegakaryocytic thrombocytopenia is an unusual hematologic disorder characterized by thrombocytopenia in association with markedly diminished bone marrow megakaryocytes. We report a case that responded to treatment with cyclosporine but not to IL-11. The bone marrow biopsy, repeated after resolution of thrombocytopenia, showed normal number of megakaryocytes.
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Affiliation(s)
- Neeraj Agarwal
- Division of Hematology, Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA
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Tristano AG. Acquired amegakaryocytic thrombocytopenic purpura: review of a not very well-defined disorder. Eur J Intern Med 2005; 16:477-81. [PMID: 16275539 DOI: 10.1016/j.ejim.2005.04.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2004] [Accepted: 04/01/2005] [Indexed: 11/17/2022]
Abstract
Acquired amegakaryocytic thrombocytopenic purpura (AATP) is a hematological disorder characterized by severe thrombocytopenia, probably due to an immunologically induced absence of megakaryocytes with a marked decrease or total absence of megakaryocytes in the bone marrow. AATP may be differentiated from other causes of peripheral destruction of platelets, such as immune thrombocytopenia (ITP). Currently, there are no standard treatments for AATP. However, immunosuppressive therapy including steroids, androgens, anti-thymocyte globulin (ATG), cyclophosphamide, cyclosporine A, immunoglobulins, splenectomy, and allogenic bone marrow transplantation (BMT) have all been utilized with varying degrees of success. However, a positive response in patients with AATP using steroids alone has rarely been reported in the literature.
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Affiliation(s)
- Antonio G Tristano
- Department of Internal Medicine, Hospital Dr. Domingo Luciani, Caracas, Venezuela.
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Felderbauer P, Ritter PR, Mattern D, Schmitz F, Bulut K, Ansorge N, Schmitt-Graeff A, Schmidt WE, Baier JE. Acquired pure megakaryocytic aplasia: a separate haematological disease entity or a syndrome with multiple causes? Eur J Haematol 2004; 72:451-4. [PMID: 15128427 DOI: 10.1111/j.1600-0609.2004.00241.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report the case of a patient with acquired pure megakaryocytic aplasia. Until today, less than 20 cases of acquired pure megakaryocytic aplasia have been reported and the disease aetiology still seems to be unclear. This report summarizes the published data concerning possible aetiologies, treatment options and outcome of patients with acquired pure megakaryocytic aplasia. Furthermore, this case report presents an example for a possible disease progression.
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Affiliation(s)
- P Felderbauer
- Department of Medicine I, St Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
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Kuwana M, Okazaki Y, Kajihara M, Kaburaki J, Miyazaki H, Kawakami Y, Ikeda Y. Autoantibody to c-Mpl (thrombopoietin receptor) in systemic lupus erythematosus: relationship to thrombocytopenia with megakaryocytic hypoplasia. ARTHRITIS AND RHEUMATISM 2002; 46:2148-59. [PMID: 12209520 DOI: 10.1002/art.10420] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine the prevalence, clinical associations, and pathogenic role of autoantibodies to c-Mpl, the thrombopoietin (TPO) receptor, in patients with systemic lupus erythematosus (SLE). METHODS Sera from 69 SLE patients, 84 patients with idiopathic thrombocytopenic purpura (ITP), and 60 healthy individuals were screened for anti-c-Mpl antibodies by enzyme-linked immunosorbent assay using recombinant c-Mpl as an antigen. Clinical findings, autoantibody profiles, and serum TPO levels were compared between SLE patients with and without anti-c-Mpl antibodies. A pathogenic role for the anti-c-Mpl antibody was evaluated by examining its inhibitory effect on TPO-dependent cell proliferation and megakaryocyte colony formation. RESULTS Serum anti-c-Mpl antibody was detected in 8 SLE patients (11.6%) and 7 ITP patients (8.3%), but in none of the healthy controls. Anti-c-Mpl antibody was associated with thrombocytopenia (P = 0.0002) and a decrease in bone marrow megakaryocytes (P = 0.02) in SLE patients. Serum TPO levels in thrombocytopenic SLE patients with anti-c-Mpl antibodies were significantly elevated compared with levels in those without the antibodies (P = 0.007). IgG fractions purified from anti-c-Mpl antibody-positive sera bound to c-Mpl expressed on the cell surface and inhibited TPO-dependent cell proliferation and megakaryocyte colony formation. CONCLUSION Autoantibody to c-Mpl is present in a subset of SLE patients with thrombocytopenia and megakaryocytic hypoplasia. It is likely that the impaired thrombopoiesis in these patients is mediated by the anti-c-Mpl antibody, which functionally blocks an interaction between TPO and c-Mpl.
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MESH Headings
- Adolescent
- Adult
- Aged
- Animals
- Autoantibodies/immunology
- Bone Marrow Cells/pathology
- Cell Division/drug effects
- Colony-Forming Units Assay
- Dose-Response Relationship, Immunologic
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Lupus Erythematosus, Systemic/blood
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/immunology
- Male
- Megakaryocytes/pathology
- Megakaryocytes/physiology
- Middle Aged
- Neoplasm Proteins
- Proto-Oncogene Proteins/blood
- Proto-Oncogene Proteins/immunology
- Proto-Oncogene Proteins/pharmacology
- Purpura, Thrombocytopenic, Idiopathic/etiology
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Receptors, Cytokine
- Receptors, Thrombopoietin
- Recombinant Proteins/blood
- Recombinant Proteins/immunology
- Recombinant Proteins/pharmacology
- Transfection
- Tumor Cells, Cultured
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Leach JW, Hussein KK, George JN. Acquired pure megakaryocytic aplasia report of two cases with long-term responses to antithymocyte globulin and cyclosporine. Am J Hematol 1999; 62:115-7. [PMID: 10577280 DOI: 10.1002/(sici)1096-8652(199910)62:2<115::aid-ajh10>3.0.co;2-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Acquired pure megakaryocytic aplasia is a rare disorder defined by severe thrombocytopenia with no other hematologic abnormalities and absent, or severely decreased marrow megakaryocytes. The etiology may be immune suppression of megakaryocyte development. Two patients are described who both responded rapidly to a combination of antithymocyte globulin and cyclosporine and who remain in remission 13-20 months after discontinuation of cyclosporine. This regimen is well described for treatment of aplastic anemia and may also be effective for acquired pure megakaryocytic aplasia.
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Affiliation(s)
- J W Leach
- Department of Medicine, University of Oklahoma Health Sciences Center, Hematology-Oncology Section, Oklahoma City, USA
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Zent CS, Ratajczak J, Ratajczak MZ, Anastasi J, Hoffman PC, Gewirtz AM. Relationship between megakaryocyte mass and serum thrombopoietin levels as revealed by a case of cyclic amegakaryocytic thrombocytopenic purpura. Br J Haematol 1999. [DOI: 10.1111/j.1365-2141.1999.01351.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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