A dose of 75 microg/kg/d of i.v. anti-D increases the platelet count more rapidly and for a longer period of time than 50 microg/kg/d in adults with immune thrombocytopenic purpura.
Treatment with 75 microg/kg/d intravenous (i.v.) anti-D was compared with 50 microg/kg/d in a prospective randomized study of 27 RhD-positive, human immunodeficiency virus-negative, adult, acute, non-splenectomized patients with immune thrombocytopenic purpura (ITP) and platelet counts < or = 30 x 109/l. The higher dose resulted in greater median d 1 (43 x 109/l vs. 7.5 x 109/l; P = 0.012) and d 7 (153 x 109/l vs. 64.5 x 109/l; P = 0.001) platelet increases despite no greater haemoglobin decrease. Children with acute ITP receiving 75 microg/kg/d had overnight platelet increases in seven out of nine cases. The duration of effect at the 75 microg/kg/d dose was 46 d vs. 21 d (P = 0.03). Adverse events were mild to moderate and ameliorated with prednisone and acetaminophen premedication.
Newman
G C
GC
Divisions of Hematology/Oncology, New York Presbyterian Hospital-Weill Medical College of Cornell University, 525 E. 68th Street, New York, NY 10021, USA.
Novoa
M V
MV
Fodero
E M
EM
Lesser
M L
ML
Woloski
B M
BM
Bussel
J B
JB
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D004334:Drug Administration Schedule; D006801:Humans; D007262:Infusions, Intravenous; D010976:Platelet Count; D011241:Prednisone / Q000627:therapeutic use; D011292:Premedication; D011446:Prospective Studies; D011696:Purpura, Thrombocytopenic / Q000097:blood / Q000628:therapy*; D018029:Rho(D) Immune Globulin / Q000008:administration & dosage*; D018709:Statistics, Nonparametric
D018712:Analgesics, Non-Narcotic; D000893:Anti-Inflammatory Agents; D018029:Rho(D) Immune Globulin; D000082:Acetaminophen; D011241:Prednisone