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Scintigraphy with Indium-111-Labeled Homologous (Donor) Platelets in the Platelet Transfusion Refractory Bone Marrow Transplant Patient

Division of Nuclear Medicine, Department of Radiology, University of Washington Medical Center, Nuclear Medicine Section, Department of Veterans Affairs Medical Center, Seattle, Washington

Correspondence: For correspondence or reprints contact: Arnold F. Jacobson, MD, PhD, Nuclear Medicine Section (115), epartment of Veterans Affairs Medical Center, 1660 South Columbian Way, Seattle, WA 98108.

ABSTRACT

Some bone marrow transplant patients who require multiple platelet transfusions as a consequence of post-transplant thrombocytopenia become refractory to these transfusions. As the spleen is the primary site of destruction for senescent and damaged platelets, splenectomy is a potential therapy for persistent thrombocytopenia. Scintigraphy with ¹¹¹In-labeled platelets has been used to identify increased splenic sequestration and destruction in various platelet disorders, especially idiopathic thrombocytopenic purpura, before consideration of therapeutic splenectomy, but this technique has not been widely described in platelet transfusion refractory bone marrow transplant patients. We report on the results of¹¹¹In-labeled platelet scans in two such patients and review the pertinent literature in relation to the possible benefits and limitations of this scanning technique.

Key Words: bone marrow • indium-111 • platelet transfusion therapy • splenectomy