Pulsed high-dose dexamethasone therapy in children with chronic idiopathic thrombocytopenic purpura.
OBJECTIVE
The effectiveness of pulsed high-dose oral dexamethasone therapy in children with refractory chronic idiopathic thrombocytopenic purpura (ITP) is evaluated.


METHODS
Seven children (5 to 16 years old) who were refractory to 2 to 5 conventional standard therapies were included in the study. Dexamethasone was administered orally at a dosage of 40 mg/m2 per day (maximum 40 mg/day) for 4 consecutive days as a cycle. The cycle was repeated once a month for 6 months.


RESULTS
One month after the first cycle, partial responses of platelet counts (> or = 50 x 10(9)/L and < 150 x 10(9)/L) were observed in three patients (43%). At the end of the sixth cycle, two patients (29%) had complete responses (> 150 x 10(9)/L) and one had a partial response. However, only one patient (14%) remained partially responsive 1 year after completion of therapy.


CONCLUSIONS
In contrast to what was observed in adults, this preliminary study suggests that pulsed high-dose oral dexamethasone therapy was not uniformly effective in children with chronic ITP.
Chen
J S
JS
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Wu
J M
JM
Chen
Y J
YJ
Yeh
T F
TF
D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003907:Dexamethasone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*
D005938:Glucocorticoids; D003907:Dexamethasone