Development of pancytopenia with neutralizing antibodies to thrombopoietin after multicycle chemotherapy supported by megakaryocyte growth and development factor by Russell L. Basser, Elizabeth O'Flaherty, Michael Green, Maria Edmonds, Janet Nichol, Dora M. Menchaca, Brian Cohen, and C. Glenn Begley Blood Volume 99(7):2599-2602 April 1, 2002 ©2002 by American Society of Hematology

Development of anti-TPO antibodies and association with thrombocytopenia, neutropenia, and anemia.Shown is the development of anti-TPO antibodies in the patient in relation to administration of PEG-rHuMGDF (shaded boxes) with chemotherapy (arrows) and G-CSF. Development of anti-TPO antibodies and association with thrombocytopenia, neutropenia, and anemia.Shown is the development of anti-TPO antibodies in the patient in relation to administration of PEG-rHuMGDF (shaded boxes) with chemotherapy (arrows) and G-CSF. Inhibitory antibody to TPO was not detected by RIA or bioassay on 6 occasions (minus signs). Inhibitory antibody to TPO was detected by RIA on 5 occasions (plus signs) and also by bioassay on 4 of these. The first sample positive on RIA was negative on bioassay. In the 4 samples positive on bioassay, inhibitory antibody to TPO was detected at serum dilutions of 1:200, 1:100, 1:100, and 1:100. (A) Platelet count, platelet transfusion requirements, and serum TPO levels (asterisks). (B) ANC. (C) Hemoglobin levels and red blood cell transfusion requirements. Russell L. Basser et al. Blood 2002;99:2599-2602 ©2002 by American Society of Hematology