Deflazacort in the treatment of haematologic disorders

Glucocorticoids (GCs) exert different activities that are useful for the treatment of several haematologic disorders. The synergistic effect with cytotoxic drugs is important for the therapy of lymphoproliferative diseases. The inhibition of macrophages prevents acute haemolysis and platelets destruction in autoimmune disorders; moreover GCS are the most important agents for the management of vasculitis complicating cryoglobulinaemia. Deflazacort (DFZ) has similar immunomodulating effects to other GCs but, by contrast, DFZ produces less hypercalciuria and hyperglycaemia than prednisone and dexamethasone. As a result, the adverse effects of prolonged treatment are less with deflazacort. In this paper we report the results obtained with DFZ containing treatment in 27 patients affected by haematological disorders: 12 patients with advanced low or intermediate grade non Hodgkin's lymphoma submitted to 6 courses of combination chemotherapy, 10 patients with acute idiopathic thrombocytopenic purpura and 5 patients with vascular purpura secondary to type 2 cryoglobulinaemia. DFZ was substituted for prednisone or 6-methylprednisolone at a dose calculated in accordance with the PDN: DFZ ratio of 0.78. The results were in accordance within what would be expected with standard treatments containing conventional GCs, whereas in most patients, the side-effects were negligible.