A follow-up study of 49 adult patients with idiopathic thrombocytopenic purpura treated with high-dose immunoglobulins and anti-D immunoglobulins.
BACKGROUND
We analyze here short- and long-term results in 49 patients with idiopathic thrombocytopenic purpura (ITP), consecutively treated with high-dose (h.d.) immunoglobulins (Ig) or anti-D Ig. The major aims of this study were to assess the prognostic power of some patient characteristics and to verify the possibility that repeated courses of treatment can induce a stable remission. Moreover, the relative efficacy and safety of these two treatments were compared.


METHODS
Group A included 28 patients with chronic ITP and 17 with ITP of recent onset who were receiving h.d. Ig; Group B included 5 patients with ITP of recent onset and 7 with chronic ITP treated with anti-D Ig. Eight cases, receiving both treatment, were included in both groups. Response to treatment was defined as any increase in platelet count above 30 x 10(9)/l, when the platelet count was less than 10 x 10(9)/l, or any doubling of the basal platelet count otherwise. Remission was defined as any platelet count higher than 100 x 10(9)/l lasting for 3 months or longer without therapy.


CONCLUSIONS
Cumulative response and remission rate was not statistically different in the two groups. Multivariate logistic regression analysis showed no influence of sex, previous therapy or duration of disease. Patients older than 60 years were definitely less responsive to h.d. Ig (58% vs 92%, p = 0.03). In Group A, two patients obtained remission after the first course of h.d. Ig. No additional remissions were obtained by repeated courses of h.d. Ig, apart from a single case of ITP of recent onset.(ABSTRACT TRUNCATED AT 250 WORDS)
Rodeghiero
F
F
Dipartimento di Ematologia, Ospedale San Bortolo, Vicenza, Italy.
Schiavotto
C
C
Castaman
G
G
Vespignani
M
M
Ruggeri
M
M
Dini
E
E
D000328:Adult; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000628:therapy*; D012074:Remission Induction; D018029:Rho(D) Immune Globulin; D013156:Splenectomy; D016896:Treatment Outcome
D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D018029:Rho(D) Immune Globulin