脉冲高剂量地塞米松疗法治疗儿童慢性特发性血小板减少性紫癜
Pulsed high-dose dexamethasone therapy in children with chronic idiopathic thrombocytopenic purpura.
作者信息
Chen J S, Wu J M, Chen Y J, Yeh T F
机构信息
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
出版信息
J Pediatr Hematol Oncol. 1997 Nov-Dec;19(6):526-9. doi: 10.1097/00043426-199711000-00007.
PURPOSE
The effectiveness of pulsed high-dose oral dexamethasone therapy in children with refractory chronic idiopathic thrombocytopenic purpura (ITP) is evaluated.
PATIENTS AND METHODS
Seven children (5 to 16 years old) who were refractory to 2 to 5 conventional standard therapies were included in the study. Dexamethasone was administered orally at a dosage of 40 mg/m2 per day (maximum 40 mg/day) for 4 consecutive days as a cycle. The cycle was repeated once a month for 6 months.
RESULTS
One month after the first cycle, partial responses of platelet counts (> or = 50 x 10(9)/L and < 150 x 10(9)/L) were observed in three patients (43%). At the end of the sixth cycle, two patients (29%) had complete responses (> 150 x 10(9)/L) and one had a partial response. However, only one patient (14%) remained partially responsive 1 year after completion of therapy.
CONCLUSIONS
In contrast to what was observed in adults, this preliminary study suggests that pulsed high-dose oral dexamethasone therapy was not uniformly effective in children with chronic ITP.
目的
评估脉冲式大剂量口服地塞米松疗法对难治性慢性特发性血小板减少性紫癜（ITP）患儿的疗效。
患者与方法
本研究纳入了7名（年龄5至16岁）对2至5种传统标准疗法均无效的患儿。地塞米松以每日40 mg/m²（最大剂量40 mg/天）的剂量口服，连续服用4天为一个周期。该周期每月重复一次，共进行6个月。
结果
在第一个周期结束后1个月，3名患者（43%）出现血小板计数部分缓解（≥50×10⁹/L且＜150×10⁹/L）。在第六个周期结束时，2名患者（29%）达到完全缓解（＞150×10⁹/L），1名患者出现部分缓解。然而，在治疗结束1年后，只有1名患者（14%）仍保持部分缓解状态。
结论
与在成人中观察到的情况不同，这项初步研究表明，脉冲式大剂量口服地塞米松疗法对慢性ITP患儿并非均有疗效。
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