Aspirin Ingestion in Primary Thrombocythemia

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Abstract
Recently Massotti et al. (14) and Patrono et al. (23) have proposed for antithrombotic therapy the use of small single dose of aspirin (ASA) every three or four days in order to inhibit thromboxane A2 production in the platelets but not to inhibit PGI2 production in the endothelium. Their data are theoretical and based on a small number of normal humans. We have examined the effect of a single ingestion of ASA (10 mg/kg) on spontaneous platelet aggregation (SPA) and collagen-induced aggregation (CA) in 11 patients with primary thrombocythemia using the original platelet-rich plasma. SPA and CA were positive in 8 out of 10 and in 11 out of 11 patients respectively before ASA ingestion. ASA abolished both types of aggregation in all patients at 12 h after the ingestion. But the recovery occurred in 1/11 in CA at 24 hr, in about half (3/8 SPA or 7/11 CA) of the patients at 48 hr, in 5/8 (SPA) and 10/11 (CA) at 72 hr and in 7/ 8 (SPA) and 11/11 (CA) at 96 hr. Since SPA and sometimes CA have been considered to be the parameters of the effect of ASA on hyperreactivity of the platelets in vivo, resulting in arterial thrombosis or insufficiency in these patients, our results suggest that daily or at least once per two days ingestion of ASA may be necessary in these patients. These results were discussed in relation to the platelet survivals (6.5–10 days) and the platelet cyclo-oxygenase or lipoxygenase activities (deficient in 3 patients for the former and in 2 for the latter) in our patients.

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