HIGH-DOSE DEXAMETHASONE IN TREATMENT OF CHILDREN WITH CHRONIC IMMUNE THROMBOCYTOPENIC PURPURA
(Abstract release date: 05/19/16)
EHA Library. Sarhan M. 06/09/16; 134982; PB2082
Prof. Mohamed Sarhan
Contributions
Contributions
Abstract
Abstract: PB2082
Type: Publication Only
Background
Chronic idiopathic thrombocytopenic purpura (ITP) is a big dilemma in hematology. About one fifth of cases diagnosed as acute ITP takes a chronic course which known as thrombocytopenia that persists after twelve months after onset. Cellular immunity plays a central role in thrombocytopenia. Alterations in T cell subsets and decreased numbers and activity of regulatory T cells are common. Cytotoxic T cells may also mediate toxicity against platelets and megakaryocytes. Treatment strategy includes first line therapy as corticosteroids, IVIG, anti-Rh (D), and second line therapy as high dose dexamethasone, anti-CD20 (rituximab), thrombopoietin receptors agonist and splenectomy.
Aims
to evaluate the therapeutic response of a high dose dexamethasone in a series of Egyptian children with chronic ITP.
Methods
The study included 27 children with chronic ITP comprising 12 males (44.4 %) and 15 females (55.6 %). One child was withdrawn from the study due to acquired diabetes and hypertension with 26 patients completing the treatment course. Dexamethasone should be administrated by intravenous infusion in a dose of 40 mg/m2/day on two divided doses for four consecutive days and repeated every 4 weeks for 6 cycles. DXA scan should be done as a baseline and after finishing therapy to evaluate bone mineral density of the patients. Repeated CBC, blood pressure, and blood glucose levels were evaluated through infusion days.
Results
Complete remission (CR) was achieved in 3 patients (11.1%) after the 1st dose, in 5 patients (18.5%) after the 2nd dose, in 5 patients (18.5%) after the 3rd dose, in 6 patients (22.2%) after the 4th dose, in 7 patients (26.9%) after the 5th dose and in 7 patients (26.9%) in the 6th dose. Assessment of the overall response after 1 months of course completion revealed that CR was achieved in 7 patients (26.9%) while remission (R) was achieved in 8 patients (30.8%) and 11 patients (42.3%) had no response. In the current study, on binary logistic regression, older age was the only significant predictor of treatment response.
Conclusion
High dose dexamethasone can be proposed as a first-line treatment for children with chronic ITP with tolerable side effects. Repeated cycles of therapy seem to be more efficient than only one cycle. Statistical significance of remission in older children, age can be considered as a predictor of treatment response.
Session topic: E-poster
Keyword(s): Children, Chronic ITP, Dexamethasone
Type: Publication Only
Background
Chronic idiopathic thrombocytopenic purpura (ITP) is a big dilemma in hematology. About one fifth of cases diagnosed as acute ITP takes a chronic course which known as thrombocytopenia that persists after twelve months after onset. Cellular immunity plays a central role in thrombocytopenia. Alterations in T cell subsets and decreased numbers and activity of regulatory T cells are common. Cytotoxic T cells may also mediate toxicity against platelets and megakaryocytes. Treatment strategy includes first line therapy as corticosteroids, IVIG, anti-Rh (D), and second line therapy as high dose dexamethasone, anti-CD20 (rituximab), thrombopoietin receptors agonist and splenectomy.
Aims
to evaluate the therapeutic response of a high dose dexamethasone in a series of Egyptian children with chronic ITP.
Methods
The study included 27 children with chronic ITP comprising 12 males (44.4 %) and 15 females (55.6 %). One child was withdrawn from the study due to acquired diabetes and hypertension with 26 patients completing the treatment course. Dexamethasone should be administrated by intravenous infusion in a dose of 40 mg/m2/day on two divided doses for four consecutive days and repeated every 4 weeks for 6 cycles. DXA scan should be done as a baseline and after finishing therapy to evaluate bone mineral density of the patients. Repeated CBC, blood pressure, and blood glucose levels were evaluated through infusion days.
Results
Complete remission (CR) was achieved in 3 patients (11.1%) after the 1st dose, in 5 patients (18.5%) after the 2nd dose, in 5 patients (18.5%) after the 3rd dose, in 6 patients (22.2%) after the 4th dose, in 7 patients (26.9%) after the 5th dose and in 7 patients (26.9%) in the 6th dose. Assessment of the overall response after 1 months of course completion revealed that CR was achieved in 7 patients (26.9%) while remission (R) was achieved in 8 patients (30.8%) and 11 patients (42.3%) had no response. In the current study, on binary logistic regression, older age was the only significant predictor of treatment response.
Conclusion
High dose dexamethasone can be proposed as a first-line treatment for children with chronic ITP with tolerable side effects. Repeated cycles of therapy seem to be more efficient than only one cycle. Statistical significance of remission in older children, age can be considered as a predictor of treatment response.
Session topic: E-poster
Keyword(s): Children, Chronic ITP, Dexamethasone
Abstract: PB2082
Type: Publication Only
Background
Chronic idiopathic thrombocytopenic purpura (ITP) is a big dilemma in hematology. About one fifth of cases diagnosed as acute ITP takes a chronic course which known as thrombocytopenia that persists after twelve months after onset. Cellular immunity plays a central role in thrombocytopenia. Alterations in T cell subsets and decreased numbers and activity of regulatory T cells are common. Cytotoxic T cells may also mediate toxicity against platelets and megakaryocytes. Treatment strategy includes first line therapy as corticosteroids, IVIG, anti-Rh (D), and second line therapy as high dose dexamethasone, anti-CD20 (rituximab), thrombopoietin receptors agonist and splenectomy.
Aims
to evaluate the therapeutic response of a high dose dexamethasone in a series of Egyptian children with chronic ITP.
Methods
The study included 27 children with chronic ITP comprising 12 males (44.4 %) and 15 females (55.6 %). One child was withdrawn from the study due to acquired diabetes and hypertension with 26 patients completing the treatment course. Dexamethasone should be administrated by intravenous infusion in a dose of 40 mg/m2/day on two divided doses for four consecutive days and repeated every 4 weeks for 6 cycles. DXA scan should be done as a baseline and after finishing therapy to evaluate bone mineral density of the patients. Repeated CBC, blood pressure, and blood glucose levels were evaluated through infusion days.
Results
Complete remission (CR) was achieved in 3 patients (11.1%) after the 1st dose, in 5 patients (18.5%) after the 2nd dose, in 5 patients (18.5%) after the 3rd dose, in 6 patients (22.2%) after the 4th dose, in 7 patients (26.9%) after the 5th dose and in 7 patients (26.9%) in the 6th dose. Assessment of the overall response after 1 months of course completion revealed that CR was achieved in 7 patients (26.9%) while remission (R) was achieved in 8 patients (30.8%) and 11 patients (42.3%) had no response. In the current study, on binary logistic regression, older age was the only significant predictor of treatment response.
Conclusion
High dose dexamethasone can be proposed as a first-line treatment for children with chronic ITP with tolerable side effects. Repeated cycles of therapy seem to be more efficient than only one cycle. Statistical significance of remission in older children, age can be considered as a predictor of treatment response.
Session topic: E-poster
Keyword(s): Children, Chronic ITP, Dexamethasone
Type: Publication Only
Background
Chronic idiopathic thrombocytopenic purpura (ITP) is a big dilemma in hematology. About one fifth of cases diagnosed as acute ITP takes a chronic course which known as thrombocytopenia that persists after twelve months after onset. Cellular immunity plays a central role in thrombocytopenia. Alterations in T cell subsets and decreased numbers and activity of regulatory T cells are common. Cytotoxic T cells may also mediate toxicity against platelets and megakaryocytes. Treatment strategy includes first line therapy as corticosteroids, IVIG, anti-Rh (D), and second line therapy as high dose dexamethasone, anti-CD20 (rituximab), thrombopoietin receptors agonist and splenectomy.
Aims
to evaluate the therapeutic response of a high dose dexamethasone in a series of Egyptian children with chronic ITP.
Methods
The study included 27 children with chronic ITP comprising 12 males (44.4 %) and 15 females (55.6 %). One child was withdrawn from the study due to acquired diabetes and hypertension with 26 patients completing the treatment course. Dexamethasone should be administrated by intravenous infusion in a dose of 40 mg/m2/day on two divided doses for four consecutive days and repeated every 4 weeks for 6 cycles. DXA scan should be done as a baseline and after finishing therapy to evaluate bone mineral density of the patients. Repeated CBC, blood pressure, and blood glucose levels were evaluated through infusion days.
Results
Complete remission (CR) was achieved in 3 patients (11.1%) after the 1st dose, in 5 patients (18.5%) after the 2nd dose, in 5 patients (18.5%) after the 3rd dose, in 6 patients (22.2%) after the 4th dose, in 7 patients (26.9%) after the 5th dose and in 7 patients (26.9%) in the 6th dose. Assessment of the overall response after 1 months of course completion revealed that CR was achieved in 7 patients (26.9%) while remission (R) was achieved in 8 patients (30.8%) and 11 patients (42.3%) had no response. In the current study, on binary logistic regression, older age was the only significant predictor of treatment response.
Conclusion
High dose dexamethasone can be proposed as a first-line treatment for children with chronic ITP with tolerable side effects. Repeated cycles of therapy seem to be more efficient than only one cycle. Statistical significance of remission in older children, age can be considered as a predictor of treatment response.
Session topic: E-poster
Keyword(s): Children, Chronic ITP, Dexamethasone
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