Published Online
on March 22, 2007

A more recent version of this article appeared on May 1, 2007

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Submitted on December 19, 2006
Accepted on January 2, 2007

Are Circulating Endothelial-Derived and Platelet-Derived Microparticles a Pathogenic Factor in the Cisplatin-Induced Stroke?

Daniel Periard MD^*; Chantal M. Boulanger PhD; Stephan Eyer MD; Nicolas Amabile MD; Paul Pugin MD; Christiane Gerschheimer;; and Daniel Hayoz MD

From the Service of Angiology (D.P., D.H.), University Hospital, Lausanne, Switzerland; INSERM (C.M.B., N.A.), Centre de Recherche Cardiovasculaire, Hôpital Lariboisière, Paris, France; the Department of Internal Medicine (S.E.), University Hospital, Lausanne, Switzerland; the Department of Internal Medicine (P.P., D.H.), Hôpital Cantonal, Fribourg, Switzerland; and the Laboratory of Hemostasis (C.G.), University Hospital, Lausanne, Switzerland.

^* To whom correspondence should be addressed. E-mail: Daniel.Periard{at}chuv.ch.

Background and Purpose--To evaluate whether cisplatin-induced stroke is mediated by vascular toxicity with release of prothrombotic endothelial and platelet-derived microparticles (MPs).

Methods--Endothelial (CD31⁺CD41^-), platelets (CD31⁺CD41⁺) and prothrombotic (Annexin V⁺) circulating MPs were quantified by flow cytometry in 18 patients with cancer, before and 3 days after administration of cisplatin, and compared with 18 healthy controls. Thrombin-antithrombin complex and prothrombin fragments (F₁₊₂) were measured as markers of the activation of the coagulation.

Results--In patients with cancer, baseline levels of circulating prothrombotic, endothelial and platelet-derived MPs were similar to healthy controls and decreased significantly after administration of cisplatin. High-baseline MPs levels were observed in 5 patients who received cisplatin for a second or third cycle. A high-baseline activation of the coagulation was observed in all patients without further increase after cisplatin infusion.

Conclusion--Cisplatin treatment is immediately followed by a decrease in circulating levels of endothelial and platelet-derived MPs. However, a transient increase in MPs is observed at the second and third infusion, and this may contribute to the cisplatin-induced stroke.

Key words: brain infarction • cancer & stroke • cisplatin • microparticles

This article has been cited by other articles:

				G. Garcia Martin, S. P. Fernandez, V. S. Castro, O. H. Cueto, and M. R. Acebal Vertebral Artery Occlusion After Chemotherapy Stroke, February 1, 2008; 39(2): e38 - e38. [Full Text] [PDF]

				D. Periard, S. Eyer, C. M. Boulanger, M. Ozsahin, and D. Hayoz Response to Letter by Garcia Martin et al Stroke, February 1, 2008; 39(2): e39 - e39. [Full Text] [PDF]