Use of intravenous anti-D in patients with refractory and relapsed immune thrombocytopenic purpura.

To determine the response to i.v. anti-D and its comparison with splenectomy as second line therapy in refractory and relapsed cases of ITP, in the Aga Khan University Hospital, Karachi.
A total of 23 patients with chronic ITP were treated with either anti-D or splenectomy as second line treatment. The patients were assessed for time to achieve a response to second line treatment, duration of response and adverse events.
There were 12 patients in the anti-D group and 11 in the splenectomy group. The mean platelet count at presentation was 9,000/cumm. The mean age was 8.9 years and 13.0 years and the male to female ratio was 1:1 and 1:1.2 in anti-D and splenectomy group respectively. 54.5% of the patient in the anti-D group responded compared to 81.8% in the splenectomy group. Median time to achieve a response was 7 days in the anti-D group and 1 day in the splenectomy group. Mean time to relapse was 87.8 days in the anti-D group and 55.4 days in the splenectomy group. No adverse events were recorded for any of the infusions of anti-D and none of the patients had more than 0.5 gm/dl fall in the hemoglobin level following anti-D infusion.
It was thus concluded that Anti-D is a relatively safe, convenient and effective therapy for chronic ITP and can be used as a splenectomy sparing agent when treatment is clinically indicated.
AuthorsR Sajid, S N Adil, Z Fadoo, S Sabir, M Khurshid
JournalJPMA. The Journal of the Pakistan Medical Association (J Pak Med Assoc) Vol. 53 Issue 11 Pg. 537-9 (Nov 2003) ISSN: 0030-9982 [Print] Pakistan
PMID14738260 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)
Chemical References
  • Isoantibodies
  • RHO(D) antibody
  • Rho(D) Immune Globulin
  • Adolescent
  • Child
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Isoantibodies
  • Male
  • Pakistan
  • Purpura, Thrombocytopenic (immunology, surgery, therapy)
  • Recurrence
  • Reproducibility of Results
  • Rho(D) Immune Globulin (therapeutic use)
  • Splenectomy
  • Treatment Outcome

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