Fc receptor blockade in patients with refractory chronic immune thrombocytopenic purpura with anti-D IgG.
Arch Med Res
; 33(6): 536-40, 2002.
Article
em En
| MEDLINE
| ID: mdl-12505098
BACKGROUND: This is an evaluation of the treatment of 63 patients with chronic immune thrombocytopenic purpura (54 splenectomized and nine nonsplenectomized) with weekly doses of anti-D (IgG)-coated red blood cells (RBCs). METHODS: All patients were given one 5-15 microg/kg/dose of intravenous (i.v.) anti-D (IgG)-coated RBCs per week (average of 300 microg/dose/week) for a median 3-month period (3-6 months). Treatment modality was evaluated on a weekly basis by platelet counts, measuring of hemoglobin levels, and performance of Coombs tests. RESULTS: All patients presented a clinical response. Fifty-two patients (82.5%) increased their platelet count (PC) and 45 (69.8%) increased their PC >50 x 10(9)/L. In 34 cases, response was sustained. Six of nine nonsplenectomized patients (67%) increased PC, thus avoiding splenectomy; four patients attained a stable complete response (CR). Similar platelet responses were observed in homozygous and heterozygous Rh (D)-positive patients (Rh/Hr phenotypes). Currently, after >10 years, 43 patients present a now permanent complete response with platelet count >50 x 10(9)/L. Ten patients subsequently decreased their platelet count, although they were able to attain CR after receiving six doses of anti-D (IgG)-coated RBCs. CONCLUSIONS: Based on our study of Fc receptor blockade treatment with anti-D (IgG)-coated RBCs with the most difficult cases of ITP, which resulted in a 69.8% successful response rate, we concluded that weekly prescription of anti-D (IgG)-coated RBCs is an effective approach to treating chronic refractory ITP.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Púrpura Trombocitopênica
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Imunoglobulina G
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Receptores Fc
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Imunoglobulina rho(D)
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Transfusão de Eritrócitos
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Eritrócitos
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Med Res
Assunto da revista:
MEDICINA
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
Estados Unidos