title: Vincristine as treatment for recurrent episodes of thrombotic thrombocytopenic purpura.
abstract: The clinical course of thrombotic thrombocytopenic purpura has dramatically improved after the introduction of plasma-based therapy, including plasma exchange and plasma infusion. However, a considerable number of patients still experience relapse after initial successful treatment. In this study, vincristine (VCR) was given as salvage treatment in 12 episodes of recurrent thrombotic thrombocytopenic purpura in seven patients, concomitantly with short-term plasma infusion. Complete remission (CR) was defined by normal platelet, hemoglobin, and serum lactic dehydrogenase (LDH) values as well as by absence of clinical signs. Of 12 patients, 12 achieved CR following therapy with VCR. The median duration of CR was 15 months (range: 2-16). Toxicity was mild consisting of paresthesias in three cases, leukopenia in one case, and autonomic neuropathy leading to paralytic ileus in one case. We conclude that VCR is remarkably effective for recurrent thrombotic thrombocytopenic purpura with acceptable toxicity.
authors.affiliation: Division of Hematology, Cardarelli Hospital, Via Niccolò Piccinni 6, 80128 Naples, Italy. felicettoferrara@katamail.com
authors.forename: F
authors.initials: F
authors.lastname: Ferrara
authors.forename: M
authors.initials: M
authors.lastname: Annunziata
authors.forename: F
authors.initials: F
authors.lastname: Pollio
authors.forename: S
authors.initials: S
authors.lastname: Palmieri
authors.forename: C
authors.initials: C
authors.lastname: Copia
authors.forename: G
authors.initials: G
authors.lastname: Mele
authors.forename: B
authors.initials: B
authors.lastname: Pocali
authors.forename: E M
authors.initials: EM
authors.lastname: Schiavone
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy*; D012008:Recurrence; D016879:Salvage Therapy; D014750:Vincristine / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine