Cancer Treatment Today

Lay Summary: IVIG is standard for ITP but represents a "holding action" rather than a cure. IVIG is approved by the FDA for use in the treatment of the following diseases: Kawasaki disease, dermato/polymyositis, idiopathic thrombocytopenic purpura (ITP), Guillain-Barre syndrome, polyneuropathy, some viral diseases, and some forms of immune deficiency. The place of IVIG in the treatment of ITP is not well clarified. It does not modify the disease

Although the record does not clearly support ITP, it is a reasonable diagnosis in the context of other CBC values. In three large cohorts of adults who had failed multiple therapeutic modalities, patients were treated with the regimen of anti-CD20 used to treat B-cell lymphoma—375 mg/m2 weekly for 4 weeks. Approximately 50% of patients had a partial or complete response, and about 33% had durable remissions. Rituximab for other than first line

Immune (or idiopathic) thrombocytopenic purpura (ITP) is commonly encountered by the practicing hematologist. Clinical management decisions have traditionally been guided by individual training and past experience. Input from the literature has been more from observational reports of case series than from scientific results of hypothesis-driven research. Practice guidelines and several surveys of clinical hematology practice have highlighted important

Adult Immune (Idiopathic) Thrombocytopenic Purpura (ITP) is a chronic and potentially serious autoimmune disorder characterized by low platelet counts in the blood. In it, platelets are destroyed by the patient's own immune system. ITP has historically been considered a disease of platelet destruction; however, recent data also suggest that the most prominent defect is the body's inability to compensate for platelet destruction by increasing production.

The Cut-off platelet cound is not known. Older literature says: one hundred thousand. While IVIG has some role in presurgical situations, plt. ct of sixty eight is probably not sufficient for the proposed surgery and would be justified. A recent review says:  "Normally, spinal or epidural anesthesia is considered safe if the platelet count is over 80,000/µl. However, the consistently low platelet counts in ITP seem to be less problematic than rapidly

There are patients with refractory autoimmune thrombocytopenia do not respond to standard therapy with high-dose corticosteroids, WinRHO, Rituxan, IVGG, and splenectomy. Cyclosporin is useful for some patients who occasionally respond to it. There are many published case reports of its effectiveness. It is recommended for refractory cases in standard reviews. Since very few pateints are this refractory, prospective studies are not possible but cyclosporine