PMC3420444_01
Trend of platelet counts, day 0 represents autologous stem cell transplantation.
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He then received four cycles of bortezomib (1.3 mg/m2 on days 1, 4, 8, 11 of 3-week schedule), lenalidomide (15 mg daily for 14 days), and dexamethasone (40 mg po weekly) from April through June of 2008; platelet counts during this treatment ranged from 121,000 to 216,000 (Figure 1). His outpatient posttransplantation course was notable for severe thrombocytopenia that was unresponsive to platelet transfusions for approximately two weeks (Figure 1). As shown in Figure 1, platelet counts steadily increased on tapering of steroid therapy.
Peripheral blood film (a) and bone marrow aspirate (b) at ITP diagnosis, both 40x magnification.
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Peripheral blood film confirmed absence of platelets and no evidence of schistocytes or dysplasia (Table 1 and Figure 2(a)). A bone marrow biopsy revealed normocellular bone marrow with trilineage hematopoiesis and adequate megakaryocytes (Table 1 and Figure 2(b)).