Platelet and immune responses to oral cyclic dexamethasone therapy in childhood chronic immune thrombocytopenic purpura

• Published in: The Journal of pediatrics 1997, Vol.130 (1), p.17-24
• Main Authors: Kühne, Thomas, Freedman, John, Semple, John W., Doyle, John, Butchart, Sheila, Blanchette, Victor S.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adolescent; Biological and medical sciences; Blood Platelets - immunology; Child; Child, Preschool; Chronic Disease; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Drug Administration Schedule; Female; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Hematologic and hematopoietic diseases; Humans; Immunoglobulins - blood; Leukocyte Count - drug effects; Male; Medical sciences; Platelet Count - drug effects; Platelet diseases and coagulopathies; Purpura, Thrombocytopenic - blood; Purpura, Thrombocytopenic - drug therapy; Purpura, Thrombocytopenic - immunology; Remission Induction
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(97)70305-6

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 × 10 9 /L, increasing to >100 × 10 9 /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 × 10 9 /L) and three partial responses (platelet count ≥50 and