Progression to AP/BP CML was defined as meeting ≥1 criterion for either AP [15%29%% blasts, <15% blasts with ≥30% blasts + promyelocytes, ≥20% basophils (blood or bone marrow) or platelet counts <100 × 10/l (blood), unless related to therapy] or BP (≥30% blasts in blood, bone marrow, or extramedullary involvement other than liver or spleen).
The patient eligibility criteria for this study were broadened to include patients with fewer transfusion requirements (as low as one transfusion within 24 months prior to initiating eculizumab treatment) and more severe bone marrow dysfunction (platelet counts as low as 30 × 10/l) (Hillmen et al, 2007; Brodsky et al, 2008).
The characteristics are megakaryocyte proliferation in the bone marrow, continuously very high platelet counts (>45 × 104/μl), and morphological abnormalities of platelets. ET is ruled out if there are morphological abnormalities of the red or white blood cells.
Long-term use, however, has been associated with serious adverse effects; linezolid can cause bone marrow suppression and low platelet counts, particularly when used for more than two weeks.
No correlation was found between the calculated absorbed doses to the bone marrow and the decrease in platelet counts, expressed as a percentage of the pretreatment value.
Patient characteristics appearing to negatively influence OS at the 0.05 level included advanced age, poorer baseline ECOG PS, poor cytogenetic risk, higher bone marrow blast counts, low baseline platelet counts, and higher WBC counts.
Additionally, poorer baseline ECOG PS and disease-related factors, such as poor cytogenetics, higher bone marrow blast counts, low baseline platelet counts, and high WBC counts, all predicted worse OS.
The ECOG performance status of 2 or better, adequate hepatic, renal and bone marrow function, and platelet count were required.
Therefore, the thrombocytopenia was attributed to marrow infiltration, although the extremely low platelet counts were incongruent with the preserved haematopoiesis.
The correlation between the radioactivity in the full bone marrow aspirate and the decrease in platelet counts was poor (r=0.35, p=0.24; Fig. 4).
