Choudhry V P, Kashyap R, Ahlawat S, Pati H P
Department of Haematology, All India Institute of Medical Sciences, New Delhi.
Int J Hematol. 1995 Apr;61(3):157-62. doi: 10.1016/0925-5710(95)00357-x.
Various drugs such as vinca alkaloids, immunoglobulins and immunosuppressant drugs have been used with variable benefits in patients with chronic idiopathic thrombocytopenic purpura (CITP) refractory to steroid therapy. Vinblastine and danazol have been shown to decrease the expression of Fc (IgG) receptors on macrophages by different mechanisms. These two drugs were used in combination, with the presumption that they will have an additive effect in the treatment of CITP. Sixteen patients with CITP between 2 and 17 years of age, resistant to steroids, were treated with vinblastine given as an intravenous bolus dose at weekly intervals for 8 weeks (the induction phase), followed at monthly intervals for the next 6 months (the maintenance phase). Danazol was given daily in doses of 2-3 mg/kg body weight during both phases. Ten of the 16 (62.5%) patients had partial to complete response and 5 of these 10 patients had sustained remission after cessation of therapy. The initial outcome with the combination of these two drugs in CITP appears to be quite promising and requires further evaluation in a larger controlled study.
多种药物，如长春花生物碱、免疫球蛋白和免疫抑制药物，已用于治疗对类固醇疗法难治的慢性特发性血小板减少性紫癜（CITP）患者，疗效各异。已证实长春碱和达那唑可通过不同机制降低巨噬细胞上Fc（IgG）受体的表达。这两种药物联合使用，推测它们在治疗CITP中会产生相加作用。16例年龄在2至17岁之间、对类固醇耐药的CITP患者，接受长春碱治疗，静脉推注给药，每周一次，共8周（诱导期），随后在接下来的6个月每月给药一次（维持期）。在两个阶段中，达那唑均按每日2 - 3mg/kg体重给药。16例患者中有10例（62.5%）有部分至完全缓解，这10例患者中有5例在治疗停止后持续缓解。这两种药物联合用于CITP的初始结果似乎很有前景，需要在更大规模的对照研究中进一步评估。
