Morphologic evaluation of megakaryocytes in immune thrombocytopenia patients older than 80 years

OBJECTIVE: In immune thrombocytopenia (ITP), which is a common acquired bleeding disorder, cytotoxic T-cell-mediated cellular immune response against both circulating platelets and bone marrow megakaryocytes are the most important mechanisms in the pathogenesis. METHODS: In our study, we evaluated the features of 33 patients with ITP, over 80 years of age. RESULTS: The median age of the patients was 90, 15 patients were female (45.4%). The mean platelet count of the patients was 39x109/L and the mean mean platelet volume was 10,33fL. Twelve patients had a target thrombocyte count greater than 30x109/L, while 20 patients had a target platelet count of 75x109/L or greater with an absolute indication of antiaggregation. In the environmental spread, 18 dysplasia findings were observed. CONCLUSION: Morphologic observations suggesting dysplasia including micromegakaryocytes and a non-dysplastic but dysmegakaryopoietic finding, multiple segmented nuclei may be related to the degree of thrombocytopenia and response to treatment. Likewise, nondysplastic features including immature forms, emperipolesis, bare nucleus, hypolobulation, and hypersegmented nucleus were related to the degree of thrombocytopenia.