Platelet function in chronic lymphocytic leukemia
Mohri, H.; Maruta, I.; Itoh, A.; Ohkubo, T.
Nihon Ketsueki Gakkai Zasshi Journal of Japan Haematological Society 48(7): 1579-1586
1985
ISSN/ISBN: 0001-5806 PMID: 4090932 Document Number: 265152
Platelet function was examined in nine patients with chronic lymphocytic leukemia (CLL). The clinical symptom of bleeding tendency was seen in two out of nine cases. The average number of platelets was 20.0 .+-. 9.3 .times. 104/.mu.l (Mean .+-. 1 SD). The platelet retention decreased in five out of eight cases. The maximal extent of aggregation induced by ADP, collagen, and epinephrine was reduced. The second wave of ADP- and epinephrine-induced aggregation was absent and the lag preceding the onset of collagen-induced aggregation was prolonged. Ristocetin-induced platelet aggregation was reduced in platelets from the stage IV patients. The intracellular concentration of ADP was significantly below normal, while the ratio of ATP/ADP was greater than normal. ATP released from platelets by Lumi-aggregometer was reduced. In patients with decreases in both retention and ristocetin-induced aggregation, VIIIR:Ag, VIII:C and VIIIR:WF were all moderately decreased. Von Willebrand abnormalities were temporary corrected by infusion of normal cryoprecipitate. Patient plasma strongly inhibited VIIIR:WF as measured with ristocetin-induced aggregation. This effect on platelet function was specific for VIIIR: WF, since there was no inhibition of ADP, collagen, or epinephrine-induced aggregation. The present study suggests that in some patients with CLL, storage pool disease and acquired von Willebrand's syndrome occurs and these abnormalities appear mainly due to immunological mechanisms.