Rodeghiero F, Schiavotto C, Castaman G, Vespignani M, Ruggeri M, Dini E
Dipartimento di Ematologia, Ospedale San Bortolo, Vicenza, Italy.
Haematologica. 1992 May-Jun;77(3):248-52.
We analyze here short- and long-term results in 49 patients with idiopathic thrombocytopenic purpura (ITP), consecutively treated with high-dose (h.d.) immunoglobulins (Ig) or anti-D Ig. The major aims of this study were to assess the prognostic power of some patient characteristics and to verify the possibility that repeated courses of treatment can induce a stable remission. Moreover, the relative efficacy and safety of these two treatments were compared.
Group A included 28 patients with chronic ITP and 17 with ITP of recent onset who were receiving h.d. Ig; Group B included 5 patients with ITP of recent onset and 7 with chronic ITP treated with anti-D Ig. Eight cases, receiving both treatment, were included in both groups. Response to treatment was defined as any increase in platelet count above 30 x 10(9)/l, when the platelet count was less than 10 x 10(9)/l, or any doubling of the basal platelet count otherwise. Remission was defined as any platelet count higher than 100 x 10(9)/l lasting for 3 months or longer without therapy.
Cumulative response and remission rate was not statistically different in the two groups. Multivariate logistic regression analysis showed no influence of sex, previous therapy or duration of disease. Patients older than 60 years were definitely less responsive to h.d. Ig (58% vs 92%, p = 0.03). In Group A, two patients obtained remission after the first course of h.d. Ig. No additional remissions were obtained by repeated courses of h.d. Ig, apart from a single case of ITP of recent onset.(ABSTRACT TRUNCATED AT 250 WORDS)
我们分析了49例特发性血小板减少性紫癜（ITP）患者连续接受大剂量（h.d.）免疫球蛋白（Ig）或抗-D Ig治疗的短期和长期结果。本研究的主要目的是评估某些患者特征的预后价值，并验证重复治疗疗程能否诱导稳定缓解的可能性。此外，还比较了这两种治疗方法的相对疗效和安全性。
A组包括28例慢性ITP患者和17例近期发病的ITP患者，他们接受h.d. Ig治疗；B组包括5例近期发病的ITP患者和7例接受抗-D Ig治疗的慢性ITP患者。8例接受过两种治疗的患者被纳入两组。当血小板计数低于10×10⁹/L时，治疗反应定义为血小板计数增加至高于30×10⁹/L，否则定义为基础血小板计数翻倍。缓解定义为血小板计数高于100×10⁹/L且持续3个月或更长时间且无需治疗。
两组的累积反应率和缓解率无统计学差异。多因素逻辑回归分析显示性别、既往治疗或病程无影响。60岁以上的患者对h.d. Ig的反应明显较差（58%对92%，p = 0.03）。在A组中，2例患者在首次h.d. Ig疗程后获得缓解。除1例近期发病的ITP患者外，重复h.d. Ig疗程未获得额外缓解。（摘要截断于250字）
