Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan,
Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
Acta Haematol. 2022;145(2):193-200. doi: 10.1159/000518744. Epub 2021 Oct 22.
To evaluate the long-term efficacy of high-dose dexamethasone (HD-DXM) treatment for immune thrombocytopenia (ITP), we retrospectively analysed 36 newly diagnosed ITP patients treated with HD-DXM as a first-line treatment. An initial response was obtained in 23 (63.9%) patients, including 11 with a complete response (CR) and 12 with a partial response (PR). Six months after HD-DXM treatment, 26 of 33 (78.8%) evaluable patients achieved objective responses, including 18 CR and 8 PR. Among 13 patients without initial response, very early increased platelet count within a week (VEIP) was observed in 7 patients, 5 (71.4%) of whom achieved a response at 6 months. In 29 patients who had available platelet count within a week, patients showing VEIP revealed longer survival than those who did not (p = 0.026). HD-DXM was an effective treatment for newly diagnosed ITP patients. VEIP after HD-DXM treatment initiation was associated with a long-term objective response in newly diagnosed ITP patients.
为了评估大剂量地塞米松(HD-DXM)治疗免疫性血小板减少症(ITP)的长期疗效,我们回顾性分析了 36 例新诊断的 ITP 患者,这些患者接受 HD-DXM 作为一线治疗。23 例(63.9%)患者获得初始反应,其中 11 例完全缓解(CR),12 例部分缓解(PR)。HD-DXM 治疗 6 个月后,33 例可评估患者中有 26 例获得客观反应,其中 18 例 CR,8 例 PR。在 13 例无初始反应的患者中,7 例在一周内出现血小板计数非常早期增加(VEIP),其中 5 例(71.4%)在 6 个月时获得反应。在 29 例有一周内血小板计数的患者中,VEIP 患者的生存期比未出现 VEIP 的患者更长(p = 0.026)。HD-DXM 是治疗新诊断 ITP 患者的有效药物。HD-DXM 治疗开始后出现 VEIP 与新诊断 ITP 患者的长期客观反应相关。