title: A single-institution, 20-year prospective experience with an affordable Fc-receptor blockade method to treat patients with chronic, refractory autoimmune thrombocytopenic purpura.
abstract: In a 20-year period in a single institution, 34 patients with chronic, refractory autoimmune thrombocytopenic purpura were prospectively treated with ex vivo anti-D opsonized autologous red blood cells. All patients had received previous treatment with steroids and/or immunosuppressive agents, and 11 had been splenectomized. Twenty one patients had an increase in the platelet count; in five cases, the increase was more than 50 x 10(9)/L platelets and in 16 the increase was more than 100 x 10(9)/L platelets. Early responses were observed in 20 patients and late responses in seven, whereas seven patients (20%) did not respond at all. Nine of the 20 individuals who achieved an ER had a subsequent drop in the platelet count; however, only three had a drop below 50 x 10(9)/L. When last censored, of the 34 patients, 24 (70%) had a platelet count above 50 x 10(9)/L. The 84-month thrombocytopenia-free (over 50 x 10(9)/L platelets) status of the whole group is 70%, whereas the 84-month complete remission (over 100 x 10(9)/L platelets) status of the whole group is 50%. It is concluded that the use of ex vivo anti-D opsonized red blood cells may represent another, substantially cheaper treatment of patients with chronic, refractory, autoimmune thrombocytopenic purpura.
authors.affiliation: Laboratorios Clinicos de Puebla.
authors.forename: Roberto
authors.initials: R
authors.lastname: Estrada-Gómez
authors.forename: Olga
authors.initials: O
authors.lastname: Vargas-Castro
authors.forename: Mabel
authors.initials: M
authors.lastname: Oropeza-Borges
authors.forename: Martha L
authors.initials: ML
authors.lastname: González-Carrillo
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Romano
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Argüelles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000191:economics; D016527:Drug Costs; D004351:Drug Resistance; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000191:economics / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007518:Isoantibodies / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009895:Opsonin Proteins / Q000627:therapeutic use*; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D017452:Receptors, IgG / Q000037:antagonists & inhibitors*; D012074:Remission Induction; D012204:Rh-Hr Blood-Group System / Q000276:immunology; D018029:Rho(D) Immune Globulin; D013156:Splenectomy
chemical_list: D007166:Immunosuppressive Agents; D007518:Isoantibodies; D009895:Opsonin Proteins; C061961:RHO(D) antibody; D017452:Receptors, IgG; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin; C026410:Rho(D) antigen