Platelet and immune responses to oral cyclic dexamethasone therapy in childhood chronic immune thrombocytopenic purpura
(1997) In Journal of Pediatrics 130(1). p.17-24- Abstract
Objective: To examine the effectiveness of cyclic oral high-dose (HD) dexamethasone therapy in pediatric patients with chronic immune thrombocytopenic purpura (ITP), which has been reported to cause complete remission in adults with chronic ITP. Study design: Eleven children with primary chronic ITP, with a median disease duration of 28 months (range, 6 to 120 months), were treated with cycles of HD dexamethasone therapy. Results: Excellent short-term responses (initial platelet counts ≤50 x 109/L, increasing to > 100 x 109/L within 72 hours of completion of an HD dexamethasone cycle) were observed in 78% of 41 cycles. Long-term effects include one complete response (platelet count ≤150 x 109/L) and... (More)
Objective: To examine the effectiveness of cyclic oral high-dose (HD) dexamethasone therapy in pediatric patients with chronic immune thrombocytopenic purpura (ITP), which has been reported to cause complete remission in adults with chronic ITP. Study design: Eleven children with primary chronic ITP, with a median disease duration of 28 months (range, 6 to 120 months), were treated with cycles of HD dexamethasone therapy. Results: Excellent short-term responses (initial platelet counts ≤50 x 109/L, increasing to > 100 x 109/L within 72 hours of completion of an HD dexamethasone cycle) were observed in 78% of 41 cycles. Long-term effects include one complete response (platelet count ≤150 x 109/L) and three partial responses (platelet count ≤50 and < 150 x 109/L) in 11 children followed for 6 or more months after completing cyclic HD dexamethasone therapy. Because side effects were substantial, three children did not complete their sixth treatment cycle. At day 6 of treatment, B lymphocytes were significantly increased (p = 0.005). Conclusions: Dexamethasone, given orally in high doses, is an effective drug in achieving short-term platelet responses, but it induced long-term remissions in fewer than half of the children with well-established chronic ITP. Its effect on B lymphocytes requires further elucidation. A prospective, controlled study will be needed to establish whether cyclic HD dexamethasone therapy can alter the natural history of children with early chronic ITP and thus avoid splenectomy.
(Less)
- author
- Kuhne, T. ; Freedman, J. ; Semple, J. W. LU ; Doyle, J. ; Butchart, S. and Blanchette, V. S.
- publishing date
- 1997-01-01
- type
- Contribution to journal
- publication status
- published
- in
- Journal of Pediatrics
- volume
- 130
- issue
- 1
- pages
- 8 pages
- publisher
- Academic Press
- external identifiers
-
- scopus:0030785539
- pmid:9003846
- ISSN
- 0022-3476
- DOI
- 10.1016/S0022-3476(97)70305-6
- language
- English
- LU publication?
- no
- id
- a0e55fb9-17a6-4779-aadc-3b0b6ac5ddd6
- date added to LUP
- 2019-12-03 10:30:36
- date last changed
- 2024-06-26 07:33:09
@article{a0e55fb9-17a6-4779-aadc-3b0b6ac5ddd6, abstract = {{<p>Objective: To examine the effectiveness of cyclic oral high-dose (HD) dexamethasone therapy in pediatric patients with chronic immune thrombocytopenic purpura (ITP), which has been reported to cause complete remission in adults with chronic ITP. Study design: Eleven children with primary chronic ITP, with a median disease duration of 28 months (range, 6 to 120 months), were treated with cycles of HD dexamethasone therapy. Results: Excellent short-term responses (initial platelet counts ≤50 x 10<sup>9</sup>/L, increasing to > 100 x 10<sup>9</sup>/L within 72 hours of completion of an HD dexamethasone cycle) were observed in 78% of 41 cycles. Long-term effects include one complete response (platelet count ≤150 x 10<sup>9</sup>/L) and three partial responses (platelet count ≤50 and < 150 x 10<sup>9</sup>/L) in 11 children followed for 6 or more months after completing cyclic HD dexamethasone therapy. Because side effects were substantial, three children did not complete their sixth treatment cycle. At day 6 of treatment, B lymphocytes were significantly increased (p = 0.005). Conclusions: Dexamethasone, given orally in high doses, is an effective drug in achieving short-term platelet responses, but it induced long-term remissions in fewer than half of the children with well-established chronic ITP. Its effect on B lymphocytes requires further elucidation. A prospective, controlled study will be needed to establish whether cyclic HD dexamethasone therapy can alter the natural history of children with early chronic ITP and thus avoid splenectomy.</p>}}, author = {{Kuhne, T. and Freedman, J. and Semple, J. W. and Doyle, J. and Butchart, S. and Blanchette, V. S.}}, issn = {{0022-3476}}, language = {{eng}}, month = {{01}}, number = {{1}}, pages = {{17--24}}, publisher = {{Academic Press}}, series = {{Journal of Pediatrics}}, title = {{Platelet and immune responses to oral cyclic dexamethasone therapy in childhood chronic immune thrombocytopenic purpura}}, url = {{http://dx.doi.org/10.1016/S0022-3476(97)70305-6}}, doi = {{10.1016/S0022-3476(97)70305-6}}, volume = {{130}}, year = {{1997}}, }