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Thromb Haemost 1990; 64(04): 501-505
DOI: 10.1055/s-0038-1647347
Original Article
Schattauer GmbH Stuttgart

The Platelet Count in Carcinoma of the Lung and Colon

Vincenzo Costantini
1   The Department of Medicine, Dartmouth Medical School and the VA Hospital, White River Junction, Vermont
,
Leo R Zacharski
1   The Department of Medicine, Dartmouth Medical School and the VA Hospital, White River Junction, Vermont
,
Thomas E Moritz
2   The Cooperative Studies Program Coordinating Center, VA Hospital, Hines, Illinois
,
Richard L Edwards
3   The Department of Medicine, University of Connecticut School of Medicine and the VA Medical Center, Newington, Connecticut, U.S.A.
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Publikationsverlauf

Received 22. März 1990

Accepted after revision09. Juli 1990

Publikationsdatum:
25. Juli 2018 (online)

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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
    CrossrefPubMedSuche in Google Scholar
  • 2 Silvis S, Turkbas N, Swaim W, Doscherholmen A. Thrombocytosis. A clinical evaluation of 322 patients. Minn Med 1969; 52: 1603-1607
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 4 Diehl WL, Mandelbaum I. The significance of thrombocytosis in patients with carcinoma of the lung. Surg Gynecol Obstet 1983; 156: 187-188
    PubMedSuche in Google Scholar
  • 5 Spigel SC, Mooney LR. Extreme thrombocytosis associated with malignancy. Cancer 1977; 39: 339-341
    CrossrefPubMedSuche in Google Scholar
  • 6 Corbett G, Perry DJ. Significance of thrombocytosis. Lancet 1: 77. 1983
    PubMedSuche in Google Scholar
  • 7 Schilling RF. Platelet millionaires. Lancet 1980; 2: 372-373
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 11 McDonald TP. Thrombopoietin: its biology, purification, and characterization. Exp Hematol 1988; 16: 201-205
    PubMedSuche in Google Scholar
  • 12 Mayur EM. Megakaryocytopoiesis and platelet production: a review. Exp Hematol 1987; 15: 340-350
    PubMedSuche in Google Scholar
  • 13 Hill RJ, Levin J. Regulators of thrombopoiesis: their biochemistry and physiology. Blood Cells 1989; 15: 141-166
    PubMedSuche in Google Scholar
  • 14 de Alarcon PA. Megakaryocyte colony-stimulating factor (Mk-CSF): its physiologic significance. Blood Cells 1989; 15: 173-185
    PubMedSuche in Google Scholar
  • 15 Burstein A, Ishibashi T. Erythropoietin and megakaryocytopoiesis. Blood Cells 1989; 15: 193-201
    PubMedSuche in Google Scholar
  • 16 Williams N, Jackson H, Walker F, Oon SH. Multiple levels of regulation of megakaryocytopoiesis. Blood Cells 1989; 15: 123-133
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 18 Bruno E, Miller ME, Hoffman R. Interacting cytokines regulate in vitro human megakaryocytopoiesis. Blood 1989; 73: 671-677
    PubMedSuche in Google Scholar
  • 19 Long MW, Hutchinson RJ, Gragowski LL, Heffner CH, Emerson SG. Synergistic regulation of human megakaryocyte development. J Clin Invest 1988; 82: 1779-1786
    CrossrefPubMedSuche in Google Scholar
  • 20 Munog-Sanz A, Barbado FJ, Pena JM, Vazquez JJ. Thrombocytopenia and carcinoma. Ann Intern Med 1984; 100: 612-613
    CrossrefPubMedSuche in Google Scholar
  • 21 Slichter SJ, Harker LA. Hemostasis in malignancy. Ann NY Acad Sci 1974; 230: 252-261
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 24 Ellis BC, Stransky A. A quick and accurate method for determination of fibrinogen in plasma. J Lab Clin Med 1961; 58: 477-488
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 27 Davidson JF, Samama MM, Desnoyers PC. Progress in Chemical Fibrinolysis and Thrombolysis (Vol. 1). Raven Press; New York: 1978
    Suche in Google Scholar
  • 28 Conover WJ. Practical Nonparametric Statistics. John Wiley & Sons; New York: 1980. pp 231-232
    Suche in Google Scholar
  • 29 Zacharski LR, Linman JW. Lymphocytopenia: its causes and significance. Mayo Clin Proc 1971; 46: 168-173
    PubMedSuche in Google Scholar
  • 30 Karpatkin S, Garg SK, Freedman ML. Role of iron as a regulator of thrombopoiesis. Am J Med 1974; 57: 521-525
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 33 Harker LA, Finch CA. Thrombokinetics in man. J Clin Invest 1969; 48: 963-974
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 36 Levin J, Bessman JD. The inverse relation between platelet volume and platelet number. J Lab Clin Med 1983; 101: 295-307
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 39 Shreiner DP, Weinberg J, Enoch D. Plasma thrombopoietin activity in humans with normal and abnormal platelet counts. Blood 1988; 56: 183-188
    PubMedSuche in Google Scholar
  • 40 Tweedy CR, Nemunaitis J, Singer JW, Roth GJ. Thrombopoietic activity of recombinant growth factors. Blood 1988; 72 (Suppl) (Suppl. 01) 342 a
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 43 Weisbart RH, Gasson JC, Golde DW. Colony-stimulating factors and host defense. Ann Intern Med 1989; 110: 297-303
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 45 Jackson CW, Simone JV, Edwards CC. The relationship of anemia and thrombocytosis. J Lab Clin Med 1974; 84: 357-368
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 47 Ascensao JL, Oken MM, Ewing SL, Goldberg RJ, Kaplan ME. Leukocytosis and large cell lung cancer. Cancer 1987; 60: 903-905
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar