Krause J R
Med Pediatr Oncol. 1982;10(1):61-5. doi: 10.1002/mpo.2950100110.
Chronic idiopathic thrombocytopenic purpura (ITP) is most often treated successfully with steroids and/or splenectomy. In those who fail to respond with the foregoing treatment, immunosuppressive drugs are sometimes added to the regimen. Cyclophosphamide has been reported heretofore to be effective with a minimum of side effects and complications. However, the use of alkylating agents and the induction of a second malignancy is now well recognized. This report describes three cases of refractory ITP treated with cyclophosphamide who subsequently developed an acute non-lymphocytic leukemia. Cyclophosphamide should be used with discretion in the treatment of chronic idiopathic thrombocytopenic purpura which is a non-neoplastic disorder.
慢性特发性血小板减少性紫癜（ITP）通常使用类固醇和/或脾切除术成功治疗。对于那些对上述治疗无反应的患者，有时会在治疗方案中添加免疫抑制药物。迄今为止，据报道环磷酰胺有效且副作用和并发症最少。然而，现在人们已经充分认识到使用烷化剂会诱发第二种恶性肿瘤。本报告描述了三例用环磷酰胺治疗的难治性ITP患者，这些患者随后发展为急性非淋巴细胞白血病。在治疗作为一种非肿瘤性疾病的慢性特发性血小板减少性紫癜时，应谨慎使用环磷酰胺。
