AUTOIMMUNE THROMBOCYTOPENIC PURPURA ASSOCIATED WITH DIFFERENT FORMS OF CANCER

Twenty-two patients with autoimmune thrombocytopenic purpura (ATP) associated with different forms of neoplasms are presented. Cancer-related ATP appeared at the time of either the clinical manifestation or relapse of the neoplastic disease, sometimes one month to 10 years after surgery and/or radio-or chemotherapy. All the patients presented high levels of both platelet-associated IgG and less frequently of serum-platelet bindable IgG. The surgical removal of the tumor performed in some thrombocytopenic patients did not induce the remission of ATP. The clinical and hematological response to steroid therapy was generally poor. The possibility of an occult tumor in patients with apparently idiopathic ATP and the possible autoimmune etiology of thrombocytopenia in cancer should therefore be considered, although the pathogenetic mechanisms of autoimmune diseases in neoplastic patients have not yet been well defined.