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[Experiences with anti-Rhesus-D therapy in pretreated patients with idiopathic thrombocytopenia]
M Pfeilstöcker1, R Waldner, R Reisner
1Ludwig-Boltzmann-Institut für Leukämieforschung und Hämatologie, Hanusch Krankenhaus, Wien, Osterreich.
Objective:
We tested the effect of anti Rhesus D [anti Rh(D)]-specific IgG in heavily pretreated patients with idiopathic thrombocytopenic purpura (ITP).
Design:
Retrospective single case studies.
Setting:
Clinical department of hematology.
Patients:
6 consecutive patients with heavily pretreated therapy-refractory ITP.
Interventions:
5 patients received one cycle of Anti Rh(D) in doses between 1,200 and 6,000 micrograms in 1 patient 2 consecutive cycles were applied. Treatment effect, durability, and side effects were monitored.
Results:
Patients after splenectomy and/or immunosuppressive therapy did not respond. Response was short-lived in 2 other patients, one long-term remission could be achieved. Responders showed slight decreases in hemoglobin indicating mild hemolysis. Other major side effects were not observed and the therapy was well tolerated.
Conclusions:
Our results suggest that therapy with Anti Rh(D) is safe and comparably inexpensive. No clear dose/effect correlation was found in our investigation. Only patients with platelet sequestration into the spleen might respond to Anti Rh(D) therapy.