A case of heparin-induced thrombocytopenia with thrombosis (HITT) is described. The patient, treated for several days with porcine Ca-heparin at a dosage of 10,000 IU/day, presented severe thrombocytopenia (Plt 36 x 10(9)/L), intermittent right leg ischemia, and a positive heparin-induced platelet aggregation assay. We promptly discontinued heparin and started picotamide, an antiplatelet drug. Rapid clinical improvement was observed in a few days. We stress the unusual features of the reported case (HITT during prophylactic therapy with low doses of porcine heparin; intermittent thrombosis), and we suggest picotamide represents a rational therapy for HITT on the basis of clinical and pathogenetic considerations.

Drug Therapy, Combination↗

PubMedDate not supplied

In vitro and in vivo activity of alkylating bombesin receptor antagonists on small cell lung carcinoma.

Bombesin (BN) and bombesin-like peptides are autocrine growth factors for small cell lung carcinoma (SCLC). BN receptor antagonists can therefore find clinical application in the treatment of this highly malignant disease. Six peptides belonging to a new class of alkylating BN analogues have been selected according to their characteristics evidenced on Swiss 3T3 fibroblasts: high binding affinity to BN receptor, relevant inhibition (> 60%) of the proliferative stimulus induced by BN, long-lasting effect and specificity for BN receptor. The six peptides were able to bind BN receptors on SCLC cells and to inhibit the growth of two SCLC cell lines: NCI-H69 and NCI-N592. Conversely, they did not inhibit the growth of tumor cell lines devoid of BN receptors. Two of them were tested in vivo on N592 cells transplanted into nude mice. The peptide carrying a Cab [p-bis(2 chloroethyl)aminobenzoyl] moiety proved to be completely inactive. The second peptide, with a Melphalan moiety (Mel), showed a moderate activity (33-45% of tumor growth inhibition) without any toxicity. The low solubility of this compound prevented the use of the higher doses in vivo.

3T3 Cells↗