RSS-Feed abonnieren
DOI: 10.1055/s-0038-1647347
The Platelet Count in Carcinoma of the Lung and Colon
Publikationsverlauf
Received 22. März 1990
Accepted after revision09. Juli 1990
Publikationsdatum:
25. Juli 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/199004/lookinside/thumbnails/10-1055-s-0038-1647347-1.jpg)
Summary
Platelet counts were evaluated in 714 patients with advanced non-small cell lung cancer (N-SCLC), small cell carcinoma of the lung (SCCL), and colon cancer entered to a clinical trial. Patients had not received prior chemotherapy. Platelet counts were not different in patients who had received radiation therapy prior to entry to the study. In comparison to the other tumor types, patients with N-SCLC demonstrated an increased prevalence of thrombocytosis (counts greater than 400,000/mm3), higher platelet counts at the time of entry to the study, higher over all mean platelet counts, relative preservation of high platelet levels during disease progression, and no relationship between platelet numbers and the amount of chemotherapy given. By contrast, platelet counts in patients with SCCL were negatively correlated with the absolute amount of cyclophosphamide and adriamycin given, and declined most dramatically with disease progression and death. Platelet numbers did not correlate with fibrinopep-tide A or fibrin split product levels suggesting that disseminated intravascular coagulation or fibrinolysis may have had less influence on platelet numbers than certain other factors. By contrast, significant correlations were found for all three tumor types between platelet numbers and other indicators of bone marrow function including anemia, total leukocyte count, and absolute neutrophil count; and the fibrinogen level. Based upon these findings, we postulate that the host response to malignancy, possibly in the form of production of bone marrow-stimulating cytokines, may play a prominent role in regulation of platelet counts in these (and perhaps other) neoplasms, and that a particularly prominent and persistent degree of marrow stimulation exists in patients with N-SCLC.
-
References
- 1 Levin J, Conley CL. Thrombocytosis associated with malignant disease. Arch Intern Med 1964; 114: 497-500
- 2 Silvis S, Turkbas N, Swaim W, Doscherholmen A. Thrombocytosis. A clinical evaluation of 322 patients. Minn Med 1969; 52: 1603-1607
- 3 Davis WM, Ross AO M. Thrombocytosis and thrombocythemia: the clinical and laboratory significance of an elevated platelet count. Am J Clin Pathol 1973; 59: 243-247
- 4 Diehl WL, Mandelbaum I. The significance of thrombocytosis in patients with carcinoma of the lung. Surg Gynecol Obstet 1983; 156: 187-188
- 5 Spigel SC, Mooney LR. Extreme thrombocytosis associated with malignancy. Cancer 1977; 39: 339-341
- 6 Corbett G, Perry DJ. Significance of thrombocytosis. Lancet 1: 77. 1983
- 7 Schilling RF. Platelet millionaires. Lancet 1980; 2: 372-373
- 8 Ebbe S. Biology of megakaryocytes. In: Progress in Hemostasis and Thrombosis, Vol. 3 Spaet T. (ed) Grune & Stratton; New York: 1977. pp 211-229
- 9 Rabellino EM. Biology of human megakaryocytes: recent developments. In: Progress in Hemostasis and Thrombosis, Vol. 7 Spaet T. (ed) Grune & Stratton; New York: 1984. pp 151-166
- 10 Loopey AF, Dyson PG, To LB. et al Recombinant human interleukin-3 stimulation of hematopoiesis in humans: loss of responsiveness with differentiation in the neutrophilic myeloid series. Blood 1988; 72: 1797-1804
- 11 McDonald TP. Thrombopoietin: its biology, purification, and characterization. Exp Hematol 1988; 16: 201-205
- 12 Mayur EM. Megakaryocytopoiesis and platelet production: a review. Exp Hematol 1987; 15: 340-350
- 13 Hill RJ, Levin J. Regulators of thrombopoiesis: their biochemistry and physiology. Blood Cells 1989; 15: 141-166
- 14 de Alarcon PA. Megakaryocyte colony-stimulating factor (Mk-CSF): its physiologic significance. Blood Cells 1989; 15: 173-185
- 15 Burstein A, Ishibashi T. Erythropoietin and megakaryocytopoiesis. Blood Cells 1989; 15: 193-201
- 16 Williams N, Jackson H, Walker F, Oon SH. Multiple levels of regulation of megakaryocytopoiesis. Blood Cells 1989; 15: 123-133
- 17 Donahue RE, Seerah J, Metzger M. et al Human IL-3 and GM-CSF act synergistically in stimulating hematopoiesis in primates. Science 1988; 241: 1820-1823
- 18 Bruno E, Miller ME, Hoffman R. Interacting cytokines regulate in vitro human megakaryocytopoiesis. Blood 1989; 73: 671-677
- 19 Long MW, Hutchinson RJ, Gragowski LL, Heffner CH, Emerson SG. Synergistic regulation of human megakaryocyte development. J Clin Invest 1988; 82: 1779-1786
- 20 Munog-Sanz A, Barbado FJ, Pena JM, Vazquez JJ. Thrombocytopenia and carcinoma. Ann Intern Med 1984; 100: 612-613
- 21 Slichter SJ, Harker LA. Hemostasis in malignancy. Ann NY Acad Sci 1974; 230: 252-261
- 22 Zacharski LR, Rickies FR, Henderson WG. et al Platelets and malignancy. Rationale and experimental design for the VA Cooperative Study of RA-233 in the treatment of cancer. Am J Clin Oncol 1982; 5: 593-609
- 23 Zacharski LR, Moritz TE, Baczek LA. et al Effect of mopidamol on survival in carcinoma of the lung and colon: Final Report of Veterans Administration Cooperative Study No. 188. J Natl Cancer Inst 1988; 80: 90-97
- 24 Ellis BC, Stransky A. A quick and accurate method for determination of fibrinogen in plasma. J Lab Clin Med 1961; 58: 477-488
- 25 Zacharski LR, Rosenstein R. Comparison of reaction rate and clot density. Methods for determination of plasma fibrinogen. Am J Clin Pathol 1988; 68: 45-52
- 26 Cronlund M, Hardin J, Burton J, Lee L, Haber E, Bloch KJ. Fibrinopeptide A in plasma of normal subjects and patients with disseminated intravascular coagulation and systemic lupus erythematosus. J Clin Invest 1976; 58: 142-151
- 27 Davidson JF, Samama MM, Desnoyers PC. Progress in Chemical Fibrinolysis and Thrombolysis (Vol. 1). Raven Press; New York: 1978
- 28 Conover WJ. Practical Nonparametric Statistics. John Wiley & Sons; New York: 1980. pp 231-232
- 29 Zacharski LR, Linman JW. Lymphocytopenia: its causes and significance. Mayo Clin Proc 1971; 46: 168-173
- 30 Karpatkin S, Garg SK, Freedman ML. Role of iron as a regulator of thrombopoiesis. Am J Med 1974; 57: 521-525
- 31 Levin J. Thrombopoiesis. In: Hemostasis and Thrombosis, 2nd edition Colman RW, Hirsh J, Marder VJ, Salzman ED. (eds) JB Lippincott; Philadelphia: 1987. pp 418-430
- 32 Briddell RA, Brandt JE, Bruno E, Straneva JE, Hoffman R. Regulation of human megakaryocytopoiesis at the level of the BFU-MK. Blood 1988; 72 (Suppl) (Suppl. 01) 317 a
- 33 Harker LA, Finch CA. Thrombokinetics in man. J Clin Invest 1969; 48: 963-974
- 34 Hill RJ, Leven RM, Levin FC, Levin J. The effect of thrombopoietin on guinea pig megakaryocyte ploidy in vitro. Blood 1988; 72 (Suppl) (Suppl. 01) 324 a
- 35 Tomer A, Friese P, Conklin R. et al Flow cytometric analysis of megakaryocytes (MKs) from patients with abnormal platelet counts. Blood 1988; 72 (Suppl) (Suppl. 01) 341 a
- 36 Levin J, Bessman JD. The inverse relation between platelet volume and platelet number. J Lab Clin Med 1983; 101: 295-307
- 37 Pfitzer P, Schneider W. Ploidy pattern of megakaryocytes in patients with metastatic tumors with and without paraneoplastic thrombosis and in controls. Haemostasis 1984; 14: 501-507
- 38 Sehayek E, Ben-Yosef N, Modan M, Chetrit A, Meytes D. Platelet parameters and aggregation in essential and reactive thrombocytosis. J Clin Pathol 1988; 90: 431-436
- 39 Shreiner DP, Weinberg J, Enoch D. Plasma thrombopoietin activity in humans with normal and abnormal platelet counts. Blood 1988; 56: 183-188
- 40 Tweedy CR, Nemunaitis J, Singer JW, Roth GJ. Thrombopoietic activity of recombinant growth factors. Blood 1988; 72 (Suppl) (Suppl. 01) 342 a
- 41 Marinkovic S, Jahreis GP, Wong GG, Baumann H. IL-6 modulates the synthesis of a specific set of acute phase plasma proteins in vivo. J Immunol 1989; 142: 808-812
- 42 Neta R, Vogel SN, Sipe JD, Wong GG, Nordan RP. Comparison of in vivo effects of human recombinant IL-1 and human recombinant IL-6 in mice. Lymphokine Res 1988; 7: 403-412
- 43 Weisbart RH, Gasson JC, Golde DW. Colony-stimulating factors and host defense. Ann Intern Med 1989; 110: 297-303
- 44 Mayur EM, Cohen JL, Newton J, Gesner TG, Mufson RA. Human serum megakaryocyte (MK) colony stimulating activity (Meg-CSA) is distinct from interleukin-3 (IL-3), granulocyte macrophage colony stimulating factor (GM-CSF), and phytohemagglutinin stimulated lymphocyte conditioned medium (PHA-LCM). Blood 1988; 72 (Suppl) (Suppl. 01) 331 a
- 45 Jackson CW, Simone JV, Edwards CC. The relationship of anemia and thrombocytosis. J Lab Clin Med 1974; 84: 357-368
- 46 Clibon U, Johnson R, Roodman GD. Erythropoietin (rhEp) maintains platelet (Pit) counts but fails to reverse the anemia in mice exposed to continuous tumor necrosis factor (TNF) in vivo. Blood 1988; 72 (Suppl) (Suppl. 01) 112 a
- 47 Ascensao JL, Oken MM, Ewing SL, Goldberg RJ, Kaplan ME. Leukocytosis and large cell lung cancer. Cancer 1987; 60: 903-905
- 48 Asano S, Urabe A, Okabe T, Sato N, Kondo Y, Ueyama Y, Chiba S, Ohsawa N, Kosaka K. Demonstration of granulopoietic factor(s) in the plasma of nude mice transplanted with a human lung cancer and in the tumor tissue. Blood 1977; 49: 845-851
- 49 Lee MY, Kaushansky K, Judkins SA, Lottsfeldt JL, Waheed A, Shadduck RK. Mechanisms of tumor-induced neutrophilia: constitutive production of colony-stimulating factors and their synergistic actions. Blood 1989; 74: 115-122