An escalating treatment strategy for children with severe chronic immune thrombocytopenia: Preliminary report from a single center

2021 ◽  
Author(s):  
Lingling Fu ◽  
Jie Ma ◽  
Hao Gu ◽  
Jingyao Ma ◽  
Yunyun Wei ◽  
...  
Keyword(s):  
Treatment Strategy ◽  
Preliminary Report ◽  
Immune Thrombocytopenia ◽  
Single Center ◽  
Chronic Immune Thrombocytopenia

scholarly journals A second-line escalating treatment strategy for children with severe chronic immune thrombocytopenia: A retrospective data from a single-center

2020 ◽  
Author(s):  
lingling FU ◽  
Jie Ma ◽  
Hao Gu ◽  
Jingyao Ma ◽  
Yunyun Wei ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Treatment Strategy ◽  
Immune Thrombocytopenia ◽  
Low Dose ◽  
High Dose ◽  
Second Line ◽  
Single Center ◽  
High Dose Dexamethasone ◽  
Number Of Patients ◽  
Chronic Immune Thrombocytopenia

Objective: To analyze the effect of a novel second-line escalating treatment strategy (high-dose dexamethasone (HDD), low-dose rituximab to eltrombopag) for children with severe chronic immune thrombocytopenia (SCITP). Materials and Methods: This study was a single-center, retrospective cohort study. The second-line escalating strategy included 3 steps: Step I (6 courses high-dose dexamethasone: HDD), Step II (HDD combined with low-dose rituximab), and Step III (eltrombopag). Results: A total of 30 cases (18 males and 12 females) were included; the median age was 8.83 (1.42-13.9) year-old, the duration time of ITP was 20.5 (12.0-96.0) months, and the platelet counts were 15 (3-29) ×109/L. After the median 14 (12-37) months’ treatment, the remission rate was 36.7% (11/30), and the sustained response (SR) rate was 68.2% (15/22). In eltrombopag (step III) cases, 47.5% (8/17) maintained platelet ≥50×109/L, 37.5% (3/8) dose tapering, and 25% (2/8) were successfully discontinued from medication. The number of patients at 12th, 24th, and 36th months was 30, 7, and 2, with the total response (TR) and remission rates of 80% (36.7%), 57.1% (28.6%), and 50% (50%), respectively. The total relapse rate was 26.7% (8/30)，three cases(75%, 3/4)from Step II and 5 cases (41.7% ,5/12)from Step III, none in Step I. Conclusion: The new second-line escalating strategy for children SCITP has an effective improving rate with 36.7% remission and 68.2% SR; 30% could benefit and retain stable response from HDD treatment. Combined treatment with eltrombopag can reduce the relapse rate of low-dose rituximab.

scholarly journals Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Jiaming Li ◽  
Zhaoyue Wang ◽  
Lan Dai ◽  
Lijuan Cao ◽  
Jian Su ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Low Dose ◽  
Group Versus ◽  
Treg Cells ◽  
Significant Rise ◽  
Control Group ◽  
Foxp3 Mrna ◽  
Experimental Group ◽  
Dose Prednisone ◽  
Chronic Immune Thrombocytopenia

We conducted this randomized trial to investigate the efficacy and safety of rapamycin treatment in adults with chronic immune thrombocytopenia (ITP). Eighty-eight patients were separated into the control (cyclosporine A plus prednisone) and experimental (rapamycin plus prednisone) groups. The CD4+CD25+CD127lowregulatory T (Treg) cells level, Foxp3 mRNA expression, and the relevant cytokines levels were measured before and after treatment. The overall response (OR) was similar in both groups (experimental group versus control group: 58% versus 62%,P=0.70). However, sustained response (SR) was more pronounced in the experimental group than in the control group (68% versus 39%,P<0.05). Both groups showed similar incidence of adverse events (7% versus 11%,P=0.51). As expected, the low pretreatment baseline level of Treg cells was seen in all patients (P<0.001); however, the experimental group experienced a significant rise in Treg cell level, and there was a strong correlation between the levels of Treg cells and TGF-beta after the treatment. In addition, the upregulation maintained a stable level during the follow-up phase. Thus, rapamycin plus low dose prednisone could provide a new promising option for therapy of ITP.

An analysis of outcomes and treatment costs for children undergoing splenectomy for chronic immune thrombocytopenia purpura

2012 ◽  
Vol 47 (8) ◽  
pp. 1537-1541 ◽  
Author(s):  
Natalie R. Gwilliam ◽  
David A. Lazar ◽  
Mary L. Brandt ◽  
Donald H. Mahoney ◽  
David E. Wesson ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Treatment Costs ◽  
Immune Thrombocytopenia Purpura ◽  
Chronic Immune Thrombocytopenia
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