Verlin M, Laros R K, Penner J A
Am J Hematol. 1976;1(1):97-104. doi: 10.1002/ajh.2830010111.
Cyclophosphamide, an immunosuppressive agent, was administered as an additional mode of therapy to 30 patients with idiopathic thrombocytopenic purpura (ITP) refractory to conventional management. Of 22 previously tested by splenectomy an excellent response was achieved in 12, who remained in complete hematologic remission for 14-96 months after therapy was discontinued; a fair response in 3, with definite increase in platelets, but not to normal levels; and a poor response in 7 who failed to improve. Of 8 nonsplenectomized patients who failed to respond to steroids or maintain a response after steroids were discontinued, 4 were considered excellent, 1 required continued therapy to remain in remission (good response), 2 were fair, and 1 was poor. Remission was observed in 2-10 weeks in both groups and appeared to be related to duration of disease; presence of disease for less than 1 year was associated with a much better response to treatment (11 of 15) when compared with disorders lasting over 2 years (6 of 15). Cyclophosphamide therapy offers additional means of treating patients with ITP who fail to respond to conventional therapy and may serve as an alternative to splenectomy when surgery is contraindicated.
环磷酰胺是一种免疫抑制剂，作为一种额外的治疗方式应用于30例对传统治疗无效的特发性血小板减少性紫癜（ITP）患者。在之前接受过脾切除术的22例患者中，12例取得了良好的反应，在治疗停止后，他们的血液学完全缓解持续了14至96个月；3例反应一般，血小板有明显增加，但未达到正常水平；7例反应较差，病情未改善。在8例未接受脾切除术且对类固醇治疗无反应或在停用类固醇后无法维持反应的患者中，4例被认为反应良好，1例需要持续治疗以维持缓解（反应较好），2例反应一般，1例反应较差。两组患者均在2至10周内观察到缓解，且似乎与病程有关；病程少于1年的疾病与治疗反应好得多（15例中的11例）相关，而病程超过2年的疾病反应则较差（15例中的6例）。环磷酰胺治疗为治疗对传统治疗无反应的ITP患者提供了额外的方法，并且在手术禁忌时可作为脾切除术的替代方法。
