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Evaluation of the effects of and earliest response rate to anti-D treatment in children with chronic idiopathic thrombocytopenic purpura: a pilot study.

Abstract
In this pilot study, 30 (14 male, 16 female; median age: 8 years, range: 2-18) chronic non-splenectomized idiopathic thrombocytopenic purpura (ITP) patients with Rh+ blood group and their 49 attacks were evaluated after intravenous (i.v.) anti-D (WinRho SDF, Cangene Corporation, Winnipeg, MB, Canada) treatment at a dose of 50 microg/kg x 3 days (n = 21 cases; 35 attacks) or a single dose of 75 microg/kg (n = 9 cases; 14 attacks) to define the hemostatic dose of anti-D. Five of 30 patients (22/49 attacks) were resistant to steroid, intravenous immunoglobulin (IVIG) and vincristine treatment. Hemoglobin (Hb), white blood cells (WBC), platelets (plt) and reticulocytes (ret) were evaluated before and after treatment during the follow-up in sequences on the 1st, 7th, 14th and 21st days after anti-D treatment if the patients had no symptom. All patients, even the resistant ones, experienced an increase in plt count to provide protection from bleeding (> or = 20 x 10(9)/L in patients with symptoms, > or = 10 x 10(9)/L in patients without symptoms). The plt responses of one resistant and five non-resistant patients treated with a single 75 microg/kg dose of i.v. anti-D in 8 attacks were monitored at the 2nd, 4th, 8th, 24th and 48th hours of the treatment. A protective plt level was attained within 2 hours in 6 attacks of five non-resistant cases and in 24 hours in the remaining 2 attacks of one resistant case. This pilot study suggests that anti-D treatment in ITP patients is effective and can increase plt to a level adequate enough to protect from hemorrhage within 2 hours, when given in a 75 microg/kg dose. A few adverse events (i.e. chills, hemolysis and hemoglobinuria) resolved without intervention.
AuthorsSevgi Yetgin, Selin Aytaç, Lale Olcay, Bahattin Tunç, Namik Ozbek, Yeşim Aydinok
JournalThe Turkish journal of pediatrics (Turk J Pediatr) 2010 Mar-Apr Vol. 52 Issue 2 Pg. 126-31 ISSN: 0041-4301 [Print] Turkey
PMID20560246 (Publication Type: Journal Article)
Chemical References
  • Immunologic Factors
  • Rh-Hr Blood-Group System
  • Rho(D) Immune Globulin
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immunologic Factors (therapeutic use)
  • Infant
  • Male
  • Pilot Projects
  • Prospective Studies
  • Purpura, Thrombocytopenic, Idiopathic (drug therapy, immunology)
  • Rh-Hr Blood-Group System (immunology)
  • Rho(D) Immune Globulin (therapeutic use)
  • Treatment Outcome

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