Posttransfusion purpura (PTP) (platelet count 5000/microliter) was diagnosed in a female patient (never transfused, gravida IV, para IV) 1 week after transfusion for hysterectomy in 1978. She did not respond to pooled random-donor platelets but recovered following a single plasma exchange. Her platelets were PlA1 negative, and her plasma contained potent anti-PlA1. In 1986, her sister (never transfused, gravida III, para III) developed PTP (platelet counts 5-15,000/microliter) following surgery-associated transfusion. She did not respond to pooled random-donor platelets. Platelet-associated IgG was markedly elevated (5365) molecules/platelet; normal, less than 660); her plasma contained a potent platelet antibody with anti-PlA1 specificity. Her platelets were subsequently shown to be PlA1 negative. The platelet count did not rise above 30,000 per microliter, despite 3 days of high-dose methylprednisolone sodium succinate and 2 weeks of prednisone (80 mg/day). Later, her platelet count increased and remained normal after steroids were discontinued. The two sisters proved to be HLA-identical, and each possessed one haplotype carrying the DR3 marker, which has been implicated as a risk factor in neonatal alloimmune thrombocytopenia associated with anti-PlA1.

Antigens, Human Platelet↗

PubMedDate not supplied

A multi-institutional retrospective study of intracranial ependymoma in children: identification of risk factors.

PURPOSE: The goal of this multi-institutional retrospective study of children with intracranial ependymoma was to identify risk factors associated with unfavorable overall survival (OS) and event-free survival (EFS). PATIENTS AND METHODS: Clinical data, including demographics, tumor location, spread, histology, details of surgery, radiation treatment, and chemotherapy were collected. Clinical characteristics and univariate and multivariate analyses of risk factors for OS and EFS are presented. RESULTS: Eleven U.S. institutions contributed 83 patients treated from 1987 to 1991. The OS at 5 and 7 years was 57% and 46%, and EFS at 5 and 7 years was 42% and 33%. Patients 3 years of age or younger differed from the older group by more common infratentorial location, less common gross total resection (GTR), and postoperative use of chemotherapy rather than radiation. This younger group of patients had worse survival (P < 0.01) than the older age group. Other than young age, less than GTR and World Health Organization (WHO) II grade 3 histology were significant adverse risk factors for EFS in univariate and multivariate analyses. OS shared the same adverse risk factors except for histology in multivariate analysis, which was only of borderline significance (P = 0.05). Progression at the original tumor location, present in 89% of patients, was the major pattern of tumor recurrence. Adjuvant chemotherapy in the group older than 3 years or craniospinal radiation in M0 patients did not significantly change EFS. CONCLUSIONS: Adverse outcome in childhood intracranial ependymoma is related to age (3 years or younger), histology (grade 3), and degree of surgical resection (less than GTR). New approaches, particularly for local tumor control in younger patients, are needed to improve survival.

Brain Neoplasms↗

PubMedDate not supplied

Sixth annual post-graduate Transcultural Nursing Seminar. Royal Waikoloan Hotel, Ahupua'a Waikoloa, Hawaii, October 25, 1995.

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Forecasting↗

PubMedDate not supplied

Anti-thymocyte globulin induced thrombocytopenia.

Anti-thymocyte globulin is strongly reactive with platelets as measured by flow cytometric analysis. This reactivity appears to be independent of human leukocyte antigen (HLA) phenotype, is dose-dependent with saturation of platelet binding sites readily achieved with concentrations of horse anti-thymocyte globulin (ATG) at 0.25 mg per ml, and cannot be blocked with human anti-PLA1 antibody nor with heat-aggregated human IgG. Results of immunoblot studies after electrophoresis of platelet membrane proteins are consistent with the proposal that horse ATG contains antibodies specific for platelet glycoproteins V and IIa.

Antibody Specificity↗

PubMedDate not supplied

Maternal platelet antibody levels in neonatal isoimmune thrombocytopenia.

A case of neonatal isoimmune thrombocytopenia (NIT) is described in which maternal platelet antibody levels decreased during the course of pregnancy. It is suggested that if this disorder is clinically suspected, maternal serum should be assessed for anti-platelet specificity using immunoblot analysis.

Adult↗