Paraneoplastic autoimmune thrombocytopenia in solid tumors
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- 作者：Maria-Theresa Krauth ; maria.krauth@meduniwien.ac.at ; [Author Vitae] ; Joe Puthenparambil ; [Author Vitae] ; Klaus Lechner ; [Author Vitae]
- 关键词：Autoimmune thrombocytopenia ; Paraneoplastic syndrome ; Solid tumors ; Treatment ; Surgery
- 刊名：Critical Reviews in Oncology/Hematology
- 出版年：2012
- 出版时间：January 2012
- 年：2012
- 卷：81
- 期：1
- 页码：75-81
- 全文大小：133 K
文摘
Immune-mediated hematological diseases are rare, but typical paraneoplastic syndromes. We have critically analyzed 68 published cases of an association of autoimmune thrombocytopenia (ITP) and solid cancers. Such cases occurred in a variety of cancers. They were most common in patients with lung and breast cancer, very rare in prostate cancer, but relatively common in renal cell and ovarian cancers. ITP occurred in about half of the patients concurrently with cancer, in about 25 % prior to cancer and in others some time after diagnosis and treatment of cancer. In the latter patients ITP was either a sign of recurrence of cancer or had other causes. In most patients ITP responded to steroid treatment. There were only few patients who had a complete response of ITP after surgical removal or chemotherapy of the cancer and there was only one patient (ITP prior to cancer) in whom a long lasting complete remission of ITP after cancer resection could be ascribed solely to cancer resection. We believe that in patients with ITP a cancer-associated ITP has always to be considered, but an extensive search for a present or future cancer is not indicated unless there is laboratory or clinical suspicion of a malignant disease. In patients with cancer associated ITP cancer resection should be done in non-metastatic cases (after appropriate pretreatment). In metastatic cases steroids are probably the treatment of choice.