title: Refractory immune thrombocytopenia. Successful treatment with repeated cyclosporine A: two case reports.
abstract: Treatment of chronic, severe refractory immune thrombocytopenia after splenectomy is difficult. Only less data exist on clinical use of cyclosporine A (CyA) in the management of refractory ITP. In this report, we describe two cases in which standard immunosuppressive therapy, other immunosuppression including cyclosporine A or splenectomy had no therapeutic effect. Even after splenectomy, recommended procedures were inefficient and critical thrombocytes count persisted. After repeated administration of cyclosporine A which had been ineffective prior to splenectomy; however, both patients achieved long-term complete remission of the ITP. Side effects of CyA were moderate. The presented cases have confirmed the potential therapeutic effect of CyA in refractory post-SE ITP.
authors.affiliation: Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc Olomouc, Czech Republic.
authors.forename: Antonin
authors.initials: A
authors.lastname: Hlusi
authors.affiliation: Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc Olomouc, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Szotkowski
authors.affiliation: Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc Olomouc, Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Indrak
keywords: Cyclosporine; ITP; refractory