ABSTRACT
Despite the unpromising results of these studies, subsequent studies were able to show in some patients benefit that at least reached statistical significance. In a wellstudied group of patients, Ziegler and co-workers presented more positive findings. In 1987 they first presented fmdings that suggested that high-dose intravenous gammaglobulin improves the response to pheresis platelets (9). A more recent study by this investigator extended Ziegler's earlier findings. In an attempt to improve platelet transfusion responses, IVIG was administered to 19 patients who were refractory to random and best available HLA-matched platelets. A response to intravenous immunoglobulin was defined as two or more successive transfusions of HLA-matched products that provided recoveries greater than 30%. Thirteen of 19 (68%) patients responded to therapy at a median time of 7 days after initiation of intravenous immunoglobulin (range 2-17 days). Baseline platelet-associated lgG levels were elevated in both the responders and the nonresponders. Post-therapy, platelet-associated lgG levels remained unchanged in the nonresponders but were decreased significantly (P < .05) in the responders. The latter levels were similar to those measured in a series of 36 transfusion-responsive patients. This decline in platelet-associated immunoglobulin was not explained by differences in lymphocytotoxic antibodies after therapy (10).
