Scintigraphy with indium-111-labeled homologous (donor) platelets in the platelet transfusion refractory bone marrow transplant patient.

Some bone marrow transplant patients who require multiple platelet transfusions as a consequence of post-transplant thrombocytopenia become refractory to these transfusions. As the spleen is the primary site of destruction for senescent and damaged platelets, splenectomy is a potential therapy for persistent thrombocytopenia. Scintigraphy with 111In-labeled platelets has been used to identify increased splenic sequestration and destruction in various platelet disorders, especially idiopathic thrombocytopenic purpura, before consideration of therapeutic splenectomy, but this technique has not been widely described in platelet transfusion refractory bone marrow transplant patients. We report on the results of 111In-labeled platelet scans in two such patients and review the pertinent literature in relation to the possible benefits and limitations of this scanning technique.