Megakaryocytopoiesis in refractory chronic immune thrombocytopenia

The extent of megakaryocytopoiesis (Mk-poiesis) and clinical outcome are evaluated in 14 patients with severe refractory chronic immune thrombocytopenia (rchr ITP). Three out of 14 patients died due to hemorrhage. The number of bleeding episodes and the number of treatment modalities proved to be both sensitive prognostic survival parameters (p < 0.05).Thirty two corticosteroid responsive chr ITP patients (chr ITP_PR), 15 not treated patients (chr ITP_NT) and 14 healthy volunteers (C) served as a control. There was a significant difference in the platelet count between the study groups (p < 0.05). The numberof megakaryocytes and promegakaryoblasts per mm³ of bone marrow were significantly lower in rchr ITP patients (p < 0.05) than in chr ITP_PR and in chr ITP_NT group, thus implying an inadequate Mk-poiesis in rITP chr patients. From the data presented here it may be suggested that the inadequate Mk-poiesis is operating in rchr ITP.