[Treatment of elderly patients with chronic idiopathic thrombocytopenic purpura]

We report a therapeutic protocol for elderly patients with chronic idiopathic thrombocytopenic purpura (ITP) and related conditions. Twelve chronic ITP patients over 60 years of age (elderly group), and 40, 59 years old or less (young group) were evaluated in this study. The therapeutic protocol for ITP, proposed by the Japanese Idiopathic Disease of Hematopoietic Organ Research Committee, was modified for the elderly (group) as follows: the initial dosage of prednisolone was reduced by half and danazol therapy was selected in cases in which splenectomy was impossible. Platelet counts and PAIgG showed no significant difference between the two groups. All 12 elderly patients were initially treated with prednisolone, and five patients responded to it. Among the seven non-responders, four patients underwent splenectomy, and the three three others (non splenectomized patients) were treated with danazol. Platelet counts were maintained over 150 x 10(3)/microliters in eleven patients except one splenectomized patient. The outcome in the elderly ITP group was better than in the young group.