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Splenectomy-sparing, long-term maintenance with anti-D for chronic immune (idiopathic) thrombocytopenic purpura: the New York Hospital experience.

Abstract
For nonsplenectomized children and adults with chronic or acute immune (idiopathic) thrombocytopenic purpura (ITP), anti-D has been shown to be a safe and effective treatment, providing hemostatic platelet increases in more than 70% of patients. Children had the best results, but all patient groups responded. In our recently published series, the effect of anti-D therapy lasted for more than 21 days in 50% of the responders and for more than 1 month in 37%. The use of anti-D as maintenance therapy was evaluated in a subset of patients. Of those who responded to the initial anti-D infusion, 79 patients (44 children, 35 adults) received 3 consecutive treatments. There were no significant differences in the responses after each infusion. Fifty-eight patients responded to all 3 treatments; of those, 20 (9 children, 11 adults) continued anti-D therapy, receiving an average of 18 infusions each (range, 10 to 36). The overall response rate was 86%. The ease of administration, duration of effect, and infrequent development of tachyphylaxis make anti-D an attractive alternative for maintenance therapy, particularly for children with ITP who have a high rate of spontaneous remissions. Use of anti-D as a means of spearing the spleen or, at least, postponing splenectomy should now be considered as a clinical option in the management of adult patients with chronic ITP.
AuthorsA Scaradavou
JournalSeminars in hematology (Semin Hematol) Vol. 37 Issue 1 Suppl 1 Pg. 42-4 (Jan 2000) ISSN: 0037-1963 [Print] United States
PMID10676924 (Publication Type: Journal Article)
Chemical References
  • Isoantibodies
  • RHO(D) antibody
  • Rho(D) Immune Globulin
Topics
  • Adult
  • Child
  • Child, Preschool
  • Hospitals, Urban
  • Humans
  • Infant
  • Isoantibodies (administration & dosage, adverse effects, therapeutic use)
  • New York
  • Purpura, Thrombocytopenic, Idiopathic (drug therapy, surgery)
  • Rho(D) Immune Globulin
  • Splenectomy
  • Time Factors
  • Treatment Outcome

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