Platelet E-News – October 18, 2005


  • Medical Advisors Publish Article: “How I Treat ITP”
  • Talecris Celebrates Second Anniversary of Gamunex®
  • High Dose Methylprednisone Impacts Bone Mineral Density in Treated Children
  • Safety Tip for Halloween
  • New Site Reporting Clinical Trial Data
  • Helping Doctors Learn What They Need to Know
  • Doctors Training to be Nicer
  • PDSA Regional Meetings in Seattle, Atlanta, and Miami
  • Desire New Orleans - You Can Help
  • Natural Herbal Treatment Developed by MDs (advertisement)



Two renowned physicians, Dr. James Bussel and Dr. Douglas Cines, both known for their ITP research and clinical work with ITP patients, explain how they treat ITP in an article in the journal “Blood”. The article is available without charge on an American Society of Hematology website, You may have to register before the article is available. Once you have registered, if required, the article is available at the following URL:

This article, “How I Treat ITP” will be of interest to patients newly diagnosed with ITP as well as patients who have been dealing with the disease for a number of years. In the article Drs. Cines and Bussel set forth their opinion, and they emphasize that it’s their opinion, regarding the best approach to “manage adults with primary idiopathic (autoimmune) thrombocytopenic purpura (ITP).”

The article addresses questions such as: Who gets ITP? How is it diagnosed? Who is treated? Who should be hospitalized? What treatments are the treatments of choice? The article also addresses persistent ITP, splenectomy, approaches to treating chronic ITP, and ITP and pregnancy.

Cines, D.B. and Bussel, J.B., How I Treat Idiopathic Thrombocytopenic Purpura (ITP), Blood (1 October 2005, Vol 106, no 7, pp2244 – 2251).


Gamunex® was introduced in the fall of 2003. It was the first completely new IGIV therapy in more than a decade. Product purity of Gamunex® is enhanced through the use of the Caprylate/Chromatography process that helps to preserve the biologic activity of the product by replacing the solvent-detergent method used in previous generations of IGIV products. Gamunex® is indicated as replacement therapy of primary humoral immunodeficiency disease (PI) and as immunomodulatory therapy for ITP.

Talecris Press Release


This study “evaluated whether repeated courses of high-dose methylprednisolone (HDMP) [prednisone] affect the lumbar spine bone mineral density (BMD) in children with chronic ITP.” The study was a retrospective analysis of 24 chronic ITP patients treated between 1992 and 2002. There were 15 male and 9 female patients included. The children were diagnosed and started treatment at a mean age of 6.7 years. They were divided in to three groups with respect to the number of courses of HDMP they received. The authors conclude that HDMP had a significant affect on lumbar BMD. While the affected lumbar BMD was not clinically significant, “some problems related to the decreased BMD might occur in these patients in the future, and we believe that they should be followed-up closely in the adult life.”

Dilber, C,, Reduced Bone Mineral Density in Childhood Chronic Idiopathic thrombocytopenic Purpura treated with High Dose Methylprednisolone, Bone, 35, 2004, pp 306-311.


The Green Guide in a recent issue offered tips for a safer Halloween. Among a much longer list of suggestions were the following: 1. Make sure your kids can both see and be seen. No masks or hats that make it difficult to see. And bright clothing or flashlights that make them visible especially to drivers. Avoid glow sticks as they may pose a health risk if they leak. 2. Avoid polyvinyl chloride masks, costumes, and accessories. They are potential health risks. 3. Decorate pumpkins with non-toxic materials. Turn to the Green Guide for a more comprehensive list of suggestions.

You can find the article at:


A new website ( has been launched by the International Federation of Pharmaceutical Manufacturers and Associations to report the results of clinical studies. Phase 1 studies on healthy volunteers are exempt and there is no obligation to report results of studies before a drug is approved. There is an obligation to publish results within one year of approval. For drugs already approved, study results are to be published within one year of the completed trial. The hope is that this site will address criticism of the pharmaceutical industry and head off governmental legislation.


Doctor-patient communication is one of most basic components of the care we receive from our physicians. To facilitate this communication, patients must be clear and as complete as possible regarding the problem or problems for which they seek help. Doctors must use the limited time available carefully, creatively, effectively, and efficiently. Health care provider Kaiser Permanente developed a program a number of years ago to provide interview training to physicians. The Kaiser program is known as the Four Habits model. While it was developed to train physicians, it provides a learning opportunity for patients who want to get the most out of their visits to their doctor. In short, the model focuses on building rapport quickly, prioritizing concerns, and looking at the problem from the patient perspective. The model emphasizes the importance of empathy and emotions in the communication. Finally the model advocates delivering the diagnosis clearly and in terms of the original concern. The end of the visit should provide a rationale for tests and treatments, summarize the visit, and indicate the next steps.

Details of the model can be found at the two sites below:

Landro, L, “Teaching Doctors How to Interview”, Wall Street Journal, September 21, 2005, p D5.


New standards from the Accreditation Council for Graduate Medical Education (ACGME) are proving to be an incentive to medical schools to move more aggressively to train doctors to be more empathetic, considerate, compassionate, in-short…nicer. Medical educators recognize a culture, a “hidden curriculum” in residency training programs that contradicts everything they have been taught about ethical behavior, compassionate care, and professionalism. The behavior that residents observe every day in the medical school environment is more important in forming attitudes and practices than the information taught in the formal course materials. This culture often includes the lessons that lead to behavior that has been described as “cold, intimidating, authoritarian, narrow-minded and disrespectful of subordinates and patients.” Fortunately this problem is being addressed. Leading medical schools are moving to incorporate standards and an evaluative process to assess progress in training “nicer” doctors. For more information see:

Landro, L, “Teaching Doctors to Be Nicer”, Wall Street Journal, September 28, 2005, p D1.


We are currently planning our regional meetings for the fall and winter season. We will host a meeting in Seattle November 5, 2005, in Atlanta December 8, 2005, and in Miami on January 21, 2006. You can find the agenda and specific location of the meetings on We update this information as it is finalized.

These meetings are a wonderful way to learn about ITP and meet others.


A message from one of our members in New Orleans

“Have you ever been to New Orleans? Didn't you just LOVE it! Maybe you saw Mardi Gras? Or the Jazz Fest? Came for a vacation, a wedding, enjoying the fabulous food, tapping with the music, tasting and toasting everything... It is our passion and duty on earth to assure that everybody we know "pass a good time". And it was always a good time in New Orleans, regardless.

But there's a HUGE problem. Similar to the ravaging effects ITP, which introduced its horrible self to me with a platelet count of 1000, Katrina is threatening our very ability to survive. Entire families are scattered across the States.

Businesses are disappearing into the bloodstream of their new post-evacuation locations. As a PDSA member for five years, it is immediately obvious no medication, IV drip, or spleen removal will stop the bleeding.

But YOU can stop it, you REALLY can! Please log on to Read what we are doing to increase our count. Desire NOLA (New Orleans, LA) is not-for-profit, led by young professionals like myself, who want to help small businesses to come back, re-open and thrive. Like the place where you tried your first gumbo, or ate your first po-boy, dunking powdered-sugar beignets into freshly-dripped cafe au lait. We know the cure. Money is the cure. Buy a shirt, share the desire, save our City. Our world-famous "joie-de-vivre" is still palpable, but the count must be increased by thousands of thousands if recovery is to be achieved. PLEASE HELP New Orleans once again say, with each one of our hearts, "Ya'll come back, real soon!"

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