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Platelet dysfunction in vincristine treated patients.

P G Steinherz, D R Miller, M W Hilgartner

    British Journal of Haematology
    |March 1, 1976
    PubMed
    Summary
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    Vincristine (VCR) impairs platelet aggregation, particularly the second phase, in patients undergoing treatment. This effect, observed for weeks after administration, suggests careful consideration for its use in non-malignant conditions.

    Area of Science:

    • Hematology
    • Pharmacology
    • Oncology

    Background:

    • Vincristine (VCR) is being reconsidered for treating idiopathic thrombocytopenic purpura.
    • Platelet function is a critical factor in hemostasis and VCR's effects require evaluation.
    • Understanding VCR's impact on platelet aggregation is essential for safe clinical application.

    Purpose of the Study:

    • To evaluate the effects of vincristine (VCR) on platelet function, specifically aggregation, in patients.
    • To determine the duration and extent of VCR-induced alterations in platelet aggregation.
    • To assess the clinical implications of VCR's impact on platelet function.

    Main Methods:

    • Studied platelet function in 18 acute lymphoblastic leukemia (ALL) patients and 9 children with solid tumors at various intervals post-VCR.

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  • Assessed platelet aggregation responses to epinephrine and collagen.
  • Monitored platelet counts, serotonin uptake/release, bleeding times, clot retraction, and platelet factor 3 release.

    • Main Results:

    • VCR significantly impaired epinephrine-induced second-phase aggregation (unobtainable in 30-67% of patients) and delayed collagen-induced aggregation.
    • Platelet aggregation defects were relative, with normal collagen-induced aggregation observed at all times.
    • Platelet adhesion was abnormal in 5/12 patients; other tested parameters remained normal.

    Conclusions:

    • Vincristine (VCR) induces a reversible thrombocytopathy characterized by impaired platelet aggregation.
    • The in vivo effect of VCR on platelets is significantly more potent than in vitro.
    • Due to its narrow therapeutic index, VCR use should be restricted to severe hematologic disorders, especially in non-malignant conditions.