scholarly journals High-dose intravenous methylprednisolone for immune thrombocytopenic purpura [letter]

Blood ◽  
1989 ◽  
Vol 73 (1) ◽  
pp. 354-355 ◽  
Author(s):  
S Ozsoylu
Keyword(s):  
Immune Thrombocytopenic Purpura ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
Thrombocytopenic Purpura

Multiagent induction and maintenance therapy for patients with refractory immune thrombocytopenic purpura (ITP)

Blood ◽  
2007 ◽  
Vol 110 (10) ◽  
pp. 3526-3531 ◽  
Author(s):  
Donna M. Boruchov ◽  
Sri Gururangan ◽  
M. Catherine Driscoll ◽  
James B. Bussel
Keyword(s):  
Maintenance Therapy ◽  
Combination Treatment ◽  
Immune Thrombocytopenic Purpura ◽  
High Dose ◽  
Treatment Combination ◽  
Intravenous Methylprednisolone ◽  
Thrombocytopenic Purpura ◽  
Acute Increase ◽  
Term Maintenance

Abstract Patients with severe immune thrombocytopenic purpura (ITP) may require an acute increase in the platelet count for surgery or ongoing hemorrhage as well as long-term maintenance treatment. Certain of these patients may be refractory to steroids, intravenous anti-D, intravenous immunoglobulin (IVIG), and splenectomy. Therefore, acute platelet increases were studied in 35 patients completely unresponsive to IVIG or high-dose steroid treatment. Because of their lack of response to either or both single agents, these patients were administered a 3- or 4-drug combination including IVIG 1 g/kg, intravenous methylprednisolone 30 mg/kg, Vinca alkaloids (VCR 0.03 mg/kg), and/or intravenous anti-D (50-75 μg/kg). Subsequent maintenance therapy with the oral combination of danazol (10-15 mg/kg) and azathioprine (2 mg/kg) was given to 18 of the 35 patients. Seventy-one percent of the patients responded to the intravenous combination treatment with acute platelet increases of at least 20×109/L to a level greater than 30×109/L. Two thirds of the patients given maintenance therapy achieved stable platelet counts greater than 50×109/L without other treatments. One patient developed an ileus, but otherwise there was little toxicity of combination treatment. Combination chemotherapy is a useful approach for patients with ITP refractory to conventional treatments both for acute induction and for long-term maintenance therapy.

A Three Year Experience at An Inner City Safety-Net Hospital with Immune Thrombocytopenic Purpura (ITP)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4684-4684
Author(s):  
Harsha V Poola ◽  
Manila Gaddh ◽  
Samuel N. Ofori ◽  
Moushmi Shah ◽  
Mohammed A. Kassem ◽  
...  
Keyword(s):  
Inner City ◽  
Immune Thrombocytopenic Purpura ◽  
Conflicts Of Interest ◽  
Hepatitis Virus ◽  
Far East ◽  
Safety Net ◽  
High Dose ◽  
Thrombocytopenic Purpura ◽  
High Dose Dexamethasone ◽  
Safety Net Hospital

Abstract Abstract 4684 Immune Thrombocytopenic Purpura or ITP remains a clinical diagnosis of exclusion. There are numerous treatments, attesting to the fallibility of each. A 3 year experience at an Inner City safety net hospital was analyzed. For inclusion in the study, the hematology service had to have excluded consumption disorders, prior chemotherapy, medication known to cause thrombocytopenia and Viral Infection- HIV and/Hepatitis. 93 patients met these criteria and had platelet counts below 50,000. The median age of the whole group was 49 yrs, with a range of 21 to 78 years. A few were ANA positive. The female preponderance reflects the literature. All Patients were started on Prednisone at 1mg/kg. Three Patients also received IV IGG to hasten the response. There were no intracranial hemorrhages or bleeding described as major. Patients from the Far East had to be excluded for Hepatitis Virus exposure. Results All who did not respond to steroids fully were treated with a second line Rx. i.e, Rituximab, Azathioprine, IV IGG or WIN Rho. One patient received high dose Dexamethasone and responded. Conclusion: Pending the use of TPO agonists, treatment of ITP in adults remains a chronic problem challenging the Hematologist to use as little corticosteroid as possible. Disclosures: No relevant conflicts of interest to declare.

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