[Thrombotic thrombocytopenic purpura (TTP) in which plasmapheresis was ineffective but vincristine slow infusion therapy was effective with long-term remission].
A 38-year old female patient with thrombotic thrombocytopenic purpura (TTP) did not respond to plasmapheresis and treatment with corticosteroids and antiplatelet agents but did respond to subsequent high-dose gamma-globulin therapy and vincristine slow infusion therapy. Remission, thought to be due to vincristine, was achieved. The administration schedule of vincristine was 1 or 2 mg once a week by intravenous drip infusion over a period of 6 to 8 hr. Improvement tended to be seen after the 6th administration, and remission was achieved after the 12th administration (total dose: 15 mg), and continues to the time of this writing. In this case, it was thought that vincristine inhibited a certain excessive reaction in the process of PAIgG-related platelet consumption. We conclude that vincristine should be administered at least 5 to 6 times, and the therapeutic method should be established based on the experience in a larger number of clinical cases.
Otsuka
E
E
Second Department of Internal Medicine, Oita Medical College.
Ohno
E
E
Ono
K
K
Saburi
Y
Y
Kikuchi
H
H
Nasu
M
M
Itoga
T
T
D000328:Adult; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D007262:Infusions, Intravenous; D010956:Plasmapheresis; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage*
D014750:Vincristine