title: Long-term salvage therapy with cyclosporin A in refractory idiopathic thrombocytopenic purpura.
abstract: Treatment of severe, chronic idiopathic thrombocytopenic purpura (ITP) refractory to most usual therapies is a difficult challenge. Little information exists on the clinical use of cyclosporin A (CyA) in the treatment of ITP. This report describes long-term treatment with CyA (median, 40 months) and follow-up (median, 36.8 months) in 12 adult patients with resistant ITP. CyA used in relatively low doses (2.5-3 mg/kg of body weight per day) led to a clinical improvement in 10 patients (83.3%). Five had a complete response (41.1%), 4 a complete response to maintenance therapy (33.3%), and one a partial response (8.3%). Two patients had no response. Most patients with a response (60%) had a long-term remission (mean, 28.6 months) after discontinuation of CyA. One patient had a relapse of ITP 4 years after CyA therapy was stopped. Side effects were moderate and transient, even in patients dependent on continued CyA treatment. CyA seems to represent reasonable salvage treatment in severe, potentially life-threatening, refractory ITP.
authors.affiliation: Department of Medical Sciences, Section of Internal Medicine and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Emilia
authors.forename: Monica
authors.initials: M
authors.lastname: Morselli
authors.forename: Mario
authors.initials: M
authors.lastname: Luppi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Longo
authors.forename: Roberto
authors.initials: R
authors.lastname: Marasca
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gandini
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ferrara
authors.forename: Nicola
authors.initials: N
authors.lastname: D'Apollo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Potenza
authors.forename: Marcello
authors.initials: M
authors.lastname: Bertesi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Torelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016572:Cyclosporine / Q000008:administration & dosage* / Q000633:toxicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000188:drug therapy*; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D016572:Cyclosporine