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Platelet E-News – June 16, 2003


  • Rituxan Clinical Update
  • Think Positive – It Helps
  • NSAIDS and ITP – A Cautionary Tale
  • British ITP Guidelines Now Available
  • One Gene – Several Autoimmune Diseases
  • New NIH Grant to Study Distant Healing and Placebo
  • Ion-Channel Immunosuppressors Offer New Hop
  • Would You Like to Postpone or Avoid Splenectomy? (advertisement)
  • Herbal Treatment (advertisement)
  • Immune Globulin Services Provided In Patients’ Homes (advertisement)



Genentech and IDEC have decided not to proceed with company-sponsored clinical development of Rituxan in ITP at this time. The trial was placed on clinical hold by the FDA, not due to concerns regarding patient safety, but due to study design issues. A number of Phase II studies have been published during the past few years showing that Rituxan may be a promising approach in the treatment of ITP.

Genentech remains committed to exploring treatment options for patients with ITP and will continue to support investigator-sponsored trials that extend current knowledge and ask novel questions. Genentech will continue to develop Rituxan for the treatment of other oncologic and autoimmune diseases.

Additionally, there is currently a compendia listing to help patients with ITP secure reimbursement for treatment with Rituxan.


Positive thoughts, even unrealistic positive thoughts, can promote health according to Shelley Taylor, a professor of psychology at the University of California, Los Angeles. In several studies of HIV positive patients she and her team found that patients who found positive meaning in their lives and the lives of others lived longer. She concludes that optimism may improve immune system function. It may also promote a healthier lifestyle, good social relationships, and assist in managing stress.

Opportunities in Science and Theology, Vol. 3 No. 10, June 2003.

(These results are consistent with our survey of Non-Traditional Treatments in ITP. In our survey 38% of the responders reported using positive thinking. Of those, more than 40% reported at least some improvement in their counts and bleeding symptoms from thinking positively. For more information on our survey results see


A patient who complained of a headache, vomiting, and earache was given various medications including ibuprofen. Ibuprofen is one type of non-steroidal anti-inflammatory drug or NSAID. A week later after the patient continued to complain of a headache and found blood in his urine, he was diagnosed with ITP (platelet count 14,000). He was given prednisone and continued on an ibuprofen drug. Later he developed an enlarged spleen, jaundice and a brain hemorrhage, resulting in a chronic neurologic disorder. After taking into consideration all of the symptoms and additional tests, it was determined that the patients brain hemorrhage was most likely due to infectious mononucleosis.

In a resulting lawsuit the patient’s lawyers argued that giving NSAIDs to someone with ITP was inconsistent with the American Society of Hematology (ASH) practice guidelines for treating ITP. Although the ASH guidelines clearly state they are recommendations, not mandates, physicians are cautioned that legal action could result if NSAIDs are give to patients with ITP.

Hem/Onc Today Vol. 4, No. 6, June 2003, p. 31

ASH ITP Treatment Guidelines are located at

For a list of NSAIDs and other substances reported to interfere with platelet function see


The British Society of Haematology has published guidelines on the treatment of ITP.
You can read them at
OR in the British Journal of Haematology, 2003, 120, 574-596, titled "Guidelines for the Investigation and Management of Immune Thrombocytopenic Purpura in Adults, Children, and Pregnancy"
There is a link to the guidelines page at


Researchers at the University of Cambridge and other locations studied the genetic make-up of patients with autoimmune thyroid disease and juvenile diabetes. They found that families with these autoimmune diseases had a lower production of CTLA-4, a protein that moderates how aggressive a T-cell will be in attacking pathogens in the immune system. They conclude that autoimmune diseases are caused in part by one from of CTLA-4. CTLA-4 works in tandem with CD28. CD28 enhances immune responses and CTLA-4 slows them. “If we could harness the profound regulatory attributes of CTLA-4 or effectively block CD28, we might be able to modify the immune response” in people with autoimmune diseases says Jeffrey A. Bluestone of the University of California at San Francisco.

Science News May 3, 2003
Nature April 30 (

(Note. ITP is an autoimmune disease)


The assumption of distant healing is that the thoughts and intentions of one person can somehow affect the health of another person from a distance. Researchers at the Institute of Noetic Sciences (IONS) are leading an NIH funded study to look at distant healing as it relates to patient knowledge and expectations. The study design will solve some of the problems of previous studies on distant healing by taking into account homogeneity in the patients, documentation of current medications, and consistency in healer background and intervention. Approximately half of the previous studies on distant healing found statistically significant effects.

IONS Noetic Sciences Review June-August, 2003


Many pharmaceutical companies are looking at regulating the signaling pathways of calcium, potassium, sodium and other molecules for new approaches to controlling disease. One of the large pharmaceutical companies is working on a compound named PAC, a type of disubstituted cyclohexyl (DSC) that inhibits the Kv1 family of potassium channels thereby inhibiting the action of T-cells. That means that compounds in the DSC family could be useful in turning off the immune system in the treatment of autoimmune diseases.

BSG BioNewsletter #15 2003 See:
Schjmalhofre WA et al. Biochemistry 2002, 41, 7781-7794