"Idiopathic thrombocytopenic purpura-like syndrome" treated with interferon in a patient with lung cancer

Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature: Part 2: Hematologic, cutaneous and vascular syndromes

The development of new immune treatment in oncology and particularly for lung cancer may induce new complications, particularly activation or reactivation of auto-immune diseases. In this context, a systematic review on the auto-immune paraneoplastic syndromes associated with lung cancer appears useful. This article is the second of a series of five and deals with hematologic, cutaneous and vascular syndromes.

Increased levels of platelet-associated immunoglobulin G in a patient with pulmonary adenocarcinoma

This report describes a rare case of thrombocytopenia with high levels of platelet-associated immunoglobulin G (PA-IgG) in a patient with an adenocarcinoma of the lung. After surgical resection, the platelet count gradually increased and the serum PA-IgG levels decreased to within normal reference ranges. These findings suggest a relationship between pulmonary adenocarcinoma and PA-IgG.

Successful treatment of idiopathic thrombocytopenic purpura-like syndrome in a cancer patient with low-dose interferon: case report and review of the literature

Idiopathic thrombocytopenic purpura (ITP)-like syndrome is a rare complication of carcinomas, and its treatment usually precedes cancer therapy in order to make further procedures safe. We describe the case of a 78-year-old man with a small-cell lung cancer of extended stage, associated with ITP-like syndrome, which proved resistant to treatment with corticosteroids and vincristine, short-responsive to IV immunoglobulin, but quickly and steadily responsive to low-dose interferon (ld IFN, 3 million IU, sc, twice weekly, for 8 weeks), until the patient's death, due to his primarily chemoresistant cancer. This case is, to our knowledge, the second reported ITP-like syndrome in a cancer patient who had been successfully treated with ld IFN. The excellent and cost-effective therapeutic index of ld IFN makes it an attractive alternative treatment in patients with this specific complication and calls for further investigation regarding its potential use as a first-line treatment.

alpha Interferon therapy in the treatment of idiopathic thrombocytopenic purpura

Treatment of patients with idiopathic thrombocytopenic purpura (ITP) varies according to the severity of the condition, the patient's age and the phase of the disease. The mainstay of treatment is corticosteroid therapy, with splenectomy for non-responding patients. For the 5%-10% of patients with refractory disease and bleeding problems, intravenous immunoglobulins are often used. Danazol achieves a response in about 30%-40% of refractory patients. At our centre, we have now treated 13 patients with interferon alfa-2b, all of whom had severe steroid-unresponsive ITP of various durations. All patients received 12 injections of 3 million units (MU) interferon subcutaneously three times a week. The platelet count rose significantly in 10 patients after interferon therapy and in one patient during therapy. Three patients had a complete response and eight a partial response. One complete responder relapsed at 5 months but again responded to retreatment with interferon. Responses were similar in splenectomized and non-splenectomized patients, and platelet-associated immunoglobulin levels remained essentially unchanged. Based on a compilation of data from this and other studies, the positive response rate (platelets at least 30-200 x 10(9)/L for at least 6 weeks) is 69% (22/32 patients). The future role and dosage of interferon in ITP remains to be determined and particularly in direct comparison with intravenous IgG therapy.