indium-oxine and Thrombocytopenia

Topics: Aged; Aortic Aneurysm; Blood Platelets; Blood Vessel Prosthesis; Cell Survival; Cerebrovascular Disorders; Heart Diseases; Humans; Indium; Ischemic Attack, Transient; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radioisotopes; Radionuclide Imaging; Thrombocytopenia; Thromboembolism; Thrombophlebitis; Time Factors

Taking into consideration the existing disagreement in the literature, the aim of this paper was to estimate the value of the initial kinetics of autologous platelets labelled with 111In-oxinate, performed during the first 20 minutes after their intravenous injection. Two hypothesis were tested: 1. Initial 111In-platelet kinetics indicates the platelet sequestration site (in patients with normal mean platelet life span)/destruction site (in patients with shortened mean platelet life span), 2. Initial 111In-platelet kinetics indicates the quality of platelet separation and labelling procedure. We performed initial labelled platelet kinetics in thrombocytopenic patients (in order to test the first hypothesis) as well as in control (healthy) subjects (in order to test the second hypothesis). Thirty-nine persons were investigated: 33 with thrombocytopenia: 25 with shortened mean platelet life span, caused by chronic im mune thrombocytopenic purpura (ITP), eight with normal platelet life span and thrombocytopenia caused by myelodysplastic syndrome (MDS), six healthy, control subjects (C). In all 39 persons platelet blood count on the day of platelet labelling was determined, autologous platelet labelling with 111In-oxinate was performed, general and differential yields of platelet labelling (GYL and DYL), as well as mean labelled platelets life span were determined. Besides that, initial labelled platelets kinetics was performed with initial 111In-platelets accumulation in the liver (IPAL) calculation, as well as the late platelet kinetics for platelet sequestration index and platelet sequestration/destruction site determination. We obtained two types of initial labelled platelets kinetics (not only in the patients with shortened platelet life span, but also in the subjects with normal labelled platelets life span), which differed in the IPAL value and in the ratio of the liver and the heart radioactivity: IPAL < 20% and IPAL>20%. We found statistically significant difference in GYL and DYL between the two groups: IPAL<20% and IPAL > 20%. Both yields were higher in IPAL<20% group. There was no significant difference between the two IPAL groups in the platelet blood count, labelled platelet life span, sequestration index and sequestration site. No correlation could be found between IPAL on one side and platelet blood count, sequestration index, and sequestration site on another. We concluded that initial labelled platelet kinetics could not indicate the platele

Topics: Adult; Blood Platelets; Female; Humans; Indium Radioisotopes; Isotope Labeling; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Platelet Transfusion; Purpura, Thrombocytopenic, Idiopathic; Thrombocytopenia

The purpose of this study was to evaluate the feasibility of a shorter method of performing platelet kinetic studies with respect to the conventional 8-9-day approach.. We studied 41 patients (28 women, 13 men; mean age 52 yr) with primary idiopathic thombocytopenic purpura (ITP) (n = 20), secondary ITP (n = 9), HCV associated thrombocytopenia (n = 9), splenectomy (n = 1) and hairy-cell leukemia (n = 1). The patients were in a steady-state of platelet turnover. Initial platelet counts ranged from 19 to 302 x 10(9)/liter (mean value = 83). Platelet survival times (PST) were measured from the blood radioactivity disappearance curve of 111In-oxine-labeled autologus platelets following the recommendations of the International Committee for Standardization in Haematology: blood samples were taken at 30 min and 2 and 4 hr and thereafter daily for 7 days. PST was calculated by the weighted mean method and ranged from 18 to 219 hr (mean value = 98). PST was also calculated using only the data collected at 2, 48 and 96 hr. If the radioactivity in the blood at 96 hr exceeded 10% of the 2-hr value, the additional point at 168 hr was used.. By using this reduced dataset, we obtained a correlation of r = 0.97 with the PST obtained from the whole dataset. In 24 patients, the difference was between +/- 10 hr and exceeded 1 day in only 4.. About 94% of the data may be recovered with only three or four blood samples and the duration may be shortened to 4 days in a significant proportion of patients (48% of ITP patients). This approach offers the advantages of increased patient throughput, compliance and reduced examination costs.

Topics: Blood Platelets; Cell Survival; Cellular Senescence; Feasibility Studies; Female; Humans; Indium Radioisotopes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Purpura, Thrombocytopenic, Idiopathic; Radionuclide Imaging; Thrombocytopenia; Time Factors

A 66-yr-old woman with cutaneous angiosarcoma of the face presented with thrombocytopenia and metastases to the skeleton. Scintigraphic imaging with 111In-oxine-labeled autologous platelets demonstrated localization of radiolabeled platelets at sites of metastatic tumor. This imaging study suggests intratumoral destruction of platelets by the metastases of the malignant vascular tumor as the cause of the patient's thrombocytopenia.

Topics: Aged; Blood Platelets; Bone Neoplasms; Facial Neoplasms; Female; Hemangioma; Humans; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombocytopenia

We have utilized 111In-labeled heterologous platelets to investigate the mechanism of thrombocytopenia in ten children. From the scintigraphic findings, platelet survival times, and clinical information, thrombocytopenia was ascribed to decreased production or to increased destruction. Two patients were found to have bone marrow production defects. Two patients with hemangiomas were studied. In one, the hemangioma was shown not to be the cause of thrombocytopenia. In the second, the hemangioma was proven the source of platelet destruction, but was much more extensive than clinically evident. In both, surgical manipulation of the hemangioma was avoided. Six additional patients had thrombocytopenia due to accelerated destruction. In four, the spleen was shown responsible. In two, however, the spleen was shown not to be responsible for the low platelet counts, and splenectomy was avoided. Thus, 111In-platelet scintigraphy and survival studies are valuable in the classification and management of childhood thrombocytopenia. We believe that this study should be performed, when possible, in any child with thrombocytopenia where the mechanism is unclear or the therapeutic intervention involves splenectomy or resection of a hemangioma.

Topics: Adolescent; Blood Platelets; Cell Survival; Child; Child, Preschool; Hemangioma; Humans; Indium Radioisotopes; Infant; Organometallic Compounds; Oxyquinoline; Platelet Count; Radionuclide Imaging; Splenectomy; Thrombocytopenia

Human platelets were labelled with aqueous 111In-tropolonate in comparison with 111In-oxinate. In normals the labelling efficiency with 111In-tropolonate was higher (93% +/- 2%) than with 111In-oxinate (67% +/- 8%) (P less than 0.05). In cases of severe thrombocytopenia, lower labelling efficiencies were obtained. In six normals a mean platelet life of 9 days +/- 3 days and an initial recovery of 59% +/- 15% were obtained. In twelve patients with thrombocytopenia the mean platelet life was 4 days +/- 4 days and the initial recovery was 58% +/- 20%. The absolute uptake of radioactivity in spleen and in liver in both groups are reported.

Topics: Blood Platelets; Cell Survival; Female; Humans; Indium; Isotope Labeling; Liver; Male; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Spleen; Thrombocytopenia; Time Factors; Tropolone

The kinetics and distribution in vivo of autologous 111-In-labelled platelets were studied in 20 patients with chronic hepatic disease. The patients, 16 of whom were thrombocytopenic, exhibited a shortened platelet mean life time, a reduced platelet recovery and a normal platelet turnover, the latter 2 of which were positively correlated to the platelet count. Platelet in vivo recovery was negatively correlated to the spleen volume. In accordance with this, scintigraphic studies revealed that the spleen was the major organ of platelet sequestration and destruction, the role of the liver being almost negligible. Signs of platelet destruction in the bone marrow were also found. Our results indicate that splenic platelet pooling and accelerated platelet destruction, accompanied by inability of the bone marrow to compensate for the thrombocytopenia are the main causes of the thrombocytopenia accompanying chronic hepatic disease.

Topics: Adult; Aged; Blood Platelets; Bone Marrow; Cell Survival; Chronic Disease; Female; Humans; Hydroxyquinolines; Indium; Kinetics; Liver; Liver Diseases; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Radioisotopes; Radionuclide Imaging; Spleen; Thrombocytopenia

Optimal labelling conditions of human platelets with 111In-oxine were determined in vitro. Based on this optimized technique, platelet mean life span (MLS) and platelet sequestration site were comparatively evaluated in 79 patients with two labels, 51Cr (n = 26) and 111In (n = 53). Patients were subgrouped according to clinical criteria as autoimmune thrombocytopenic purpura (AITP) (group 1; n = 49), hypersplenism (2; n = 12), impaired thrombopoiesis (3; n = 3), unclassified thrombocytopenia (4; n = 6), and nonthrombocytopenic patients (5; n = 9). In patients with AITP and hypersplenism the mean values for the MLS determined either with 51Cr or with 111In were lowered but the difference was not statistically significant, neither for group 1 (18.6 h vs 17.3 h; P greater than 0.2) nor for group 2 (94.7 vs 122.3 h; P greater than 0.2). The correlation between MLS and platelet counts in patients with AITP was significant for both labels (P less than 0.001). The 15 min recovery tended to be higher with 111In in all groups, but the difference was significant (P less than 0.05) only for group 1. The sequestration sites were similar with both labels. We conclude that, contrary to previous reports, platelet survival studies yield similar results with both the 51Cr and 111In methods. Due to its distinct advantages 111In is the label of choice for investigation of platelet kinetics.

Topics: Blood Platelets; Cell Survival; Chromium Radioisotopes; Hematopoiesis; Humans; Hydroxyquinolines; Hypersplenism; Indium; Organometallic Compounds; Oxyquinoline; Purpura, Thrombotic Thrombocytopenic; Radioisotopes; Radionuclide Imaging; Thrombocytopenia

A 4-year-old boy presented with consumptive coagulopathy suspected to be due to Kasabach-Merritt syndrome. Localization of homologous indium-111 platelets in the region of the right sacral ala confirmed that this was the site of disease and facilitated radiation treatment, which proved to be curative.

Topics: Blood Platelets; Child, Preschool; Hemangioma; Humans; Hydroxyquinolines; Indium; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Spinal Neoplasms; Syndrome; Thrombocytopenia

We have used homologous platelet labelling with 111In oxine in the diagnosis of thrombocytopenia occurring in a patient who had received two renal transplants. The technique enabled us to prove that platelet destruction was occurring in the right-sided, non-functioning transplant. In the presence of moderately impaired bone marrow function, this destructive process was sufficient to cause thrombocytopenia. Transplant nephrectomy relieved the thrombocytopenia.

Topics: Blood Platelets; Cell Survival; Female; Graft Rejection; Humans; Hydroxyquinolines; Indium; Kidney Transplantation; Middle Aged; Organometallic Compounds; Oxyquinoline; Platelet Count; Radioisotopes; Radionuclide Imaging; Thrombocytopenia