Megakaryocytopoiesis in refractory chronic immune thrombocytopenia

The extent of megakaryocytopoiesis (Mk-poiesis) and clinical outcome are ev aluated in 14 patients with severe refractory chronic immune thrombocytopen ia (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 bo th sensitive prognostic survival parameters (p < 0.05). Thirty two corticosteroid responsive chr ITP patients (chr ITPPR), 15 not t reated patients (chr ITPNT) and 14 healthy volunteers (C) served as a contr ol. There was a significant difference in the platelet count between the st udy groups (p < 0.05). The number of megakaryocytes and promegakaryoblasts per mm(3) of bone marrow were significantly lower in rchr ITP patients (p < 0.05) than in chr ITP,, and in chr ITP,, group, thus implying an inadequat e Mk-poiesis in rITP chr patients. From the data presented here it may be s uggested that the inadequate Mk-poiesis is operating in rchr ITP.