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Platelet E-News – February 15, 2003

This e-newsletter is a monthly publication of The Platelet Disorder Support Association. The information in this newsletter is for educational purposes only. For advice on your unique medical condition, please consult a health care professional.


  • Things you should know about smallpox vaccine
  • Rituxan now in the USP Drug Information Listing
  • Viagra and platelets
  • Loud noise increases cell damage
  • World Health Organization reports on improving your health



In these volatile times, it is sometimes difficult to know the best course of action. Here’s some information that may help with any decisions you and your family face concerning smallpox vaccine.

“Patients with immune deficiency disorders and their household contacts should not be vaccinated…Any person with a condition that requires the use of prednisone or other immunosuppressive agents should not receive the smallpox vaccine at this time… If there were to be outbreaks of smallpox associated with bioterrorism, these people should check with their doctors before considering smallpox vaccination,” state Dr. Neal Halsey, Department of International Health, Johns Hopkins School of Medicine, and Dr. Noel Rose, Autoimmune Disease Research Center, Johns Hopkins University in a report written for the American Autoimmune Disease Related Association. For the full report see:

You can receive more smallpox and vaccine information from the National Vaccine Information Center. See:


The USP Drug Information Listing is a compendium recommending how therapeutics should be reimbursed for different diseases and conditions. The most recent USP Drug Information Listing (Vol. I, January 2003) has accepted Rituxan for the treatment of ITP for the first three doses. Although the FDA has not approved Rituxan for the treatment of ITP, the cost of the first three doses of Rituxan may be covered by managed care based on the USP DI's listing.

See: and


Researchers have now linked the action of Sildenafil (Viagra) directly to some deaths from heart attacks. Sildenafil (Viagra) stimulates the production of an enzyme called PKG (cGMP–dependent protein kinase). Researchers have long known that PKG keeps platelets from sticking together. Now researchers at the University of Illinois College of Medicine report that PKG plays a dual role, first promoting platelet aggregation, then later, inhibiting platelet function. They found that PKG made platelets clingier only when natural blood-clotting stimulants were present. After several minutes, platelets became less sticky.

From Science News, January 18, 2003. See:

(Avoiding substances that inhibit platelet function is fairly obvious for someone with few platelets. However, Viagra can pose a dual problem for patients with ITP, especially those without spleens. A study published in the July 16, 1977 issue of the Lancet “Splenectomy and Subsequent Mortality in Veterans of the 1935-45 war” concluded that the splenectomized veterans they studied had increased mortality due to heart disease. During a meeting associated with the 2001 American Society of Hematology conference, Dr. Ahn from the University of Miami reported on the unusual incidence of small strokes and heart problems among his ITP patients. For more information see The Platelet News, Winter 2001,


Loud noise can increase free radicals and damage DNA, according to researchers at the University of Pisa in Italy. They blasted 10 male lab rats with 100 decibel noise, the volume heard in some dance clubs, then analyzed their cells. They found the rats subjected to the loud noise had more broken cell membranes than those held in a quieter environment. “Loud sound sensed by the auditory system can trigger a surge in blood concentrations of the hormone norephephrine, which stimulates heart cells to absorb too much calcium. That can weaken the membranes of the mitochondria and cause them to release free radicals,” notes Pisa geneticist Giada Frenzilli. In the past, loud noise has also been linked to high blood pressure and heart disease. Other researchers suggest that the loud noise causes stress and it is the stress that is responsible for the damage. See:

(At the 2002 American Society of Hematology Meeting, some researchers reported on the link between free radicals and ITP. We will have more information on the ASH conference in our next issue of The Platelet News…ed.)


The World Health Report 2002 – Reducing Risks, Promoting Healthy Life concluded that life expectancy could be increased by five to ten years if government and individuals address the major health risks. The top ten global risks are childhood and maternal underweight; unsafe sex; high blood pressure; tobacco and alcohol use; unsafe water, sanitation, and hygiene; high cholesterol; indoor smoke from solid fuels; iron deficiency, and overweight and obesity. The health risks differ markedly between richer and poorer nations. According to Christopher Murray, MD, PhD, director of WHO’s World Health Report 2002, “Globally, we need to achieve a much better balance between preventing disease and merely treating its consequences.”

From Hem/Onc Today, January 2003, pp. 15-17

The full report is available in all six WHO official languages - English, French Spanish, Arabic, Chinese and Russian –See: