HIGH DOSE PULSE DEXAMETHASONE THERAPY IN CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

Area of Science:

• Hematology
• Immunology
• Pharmacology

Background:

• Chronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet counts.
• Patients refractory to standard therapies, including prednisolone, danazol, and splenectomy, often have limited treatment options.

Purpose of the Study:

• To evaluate the efficacy and safety of pulse high-dose dexamethasone (DXM) in patients with symptomatic chronic ITP resistant to conventional treatments.
• To assess treatment response and identify potential prognostic factors for successful outcomes.

Main Methods:

• A cohort of 12 patients with chronic ITP received six cycles of dexamethasone (40 mg/day for 4 days every 4 weeks).
• Treatment response was assessed by platelet count (PLT) at the end of the sixth cycle and at 1-year follow-up.
• Adverse events associated with DXM therapy were systematically recorded.

Main Results:

• After six cycles, 58% (7/12) achieved complete response (CR; PLT ≥ 100 × 10^9/L), 8% (1/12) partial response (PR; PLT 50-100 × 10^9/L), and 33% (4/12) were non-responders (NR; PLT < 50 × 10^9/L).
• At 1-year follow-up, 33.3% of patients were in CR, 33.3% in PR, and 33.3% in NR.
• Common side effects included increased appetite (66.6%), hyperalertness (50%), abdominal discomfort (41.6%), and nausea/vomiting (16.6%).

Conclusions:

• Pulse high-dose dexamethasone is an effective treatment option for a significant proportion of chronic ITP patients refractory to standard therapies.
• No predictive laboratory or chemical parameters were identified to forecast treatment success.
• Further research is warranted to optimize treatment strategies and identify predictors of response in refractory ITP.