Original Article

Korean J Hematol 2009; 44(1):

Published online March 30, 2009

https://doi.org/10.5045/kjh.2009.44.1.22

© The Korean Society of Hematology

특발성 혈소판 감소성 자반증 환자의 초치료로서 고용량 덱사메타손 요법

윤진아 김찬규 김세형 김경하 김현정 박성규 이상철 이남수 배상병 이규택 원종호 박희숙 홍대식

순천향대학교 의과대학 내과학교실, 종양혈액내과학교실

Initial Therapy with High-Dose Dexamethasone for Patients with Idiopathic Thrombocytopenic Purpura

Jin Ah Yoon, Chan Kyu Kim, Se Hyung Kim, Kyung Ha Kim, Hyun Jung Kim, Sung Kyu Park, Sang Chul Lee, Nam Su Lee, Sang Byung Bae, Kyu Taek Lee, Jong Ho Won, Hee Sook Park, Dae Sik Hong

Department of Internal Medicine, Division of Hematology and Oncology, College of Medicine, Soonchunhyang University, Bucheon, Korea

Abstract

Background: Corticosteroids have been widely used for treatingidiopathic thrombocytopenic purpura (ITP) as a first-line treatment. Several different pulsed high-dose dexamethasone therapies for adult ITP have been reported on. We assessed the effectiveness of a single course of high dose dexamethasone as first-line treatment for adult patients with ITP.
Methods: The subjects of the study were previously untreated adult patients with newly diagnosed ITP and who had a platelet count of less than 20,000/ՌL or a platelet count less than 50,000/ՌL. High-dose dexamethasone at a dose of 40mg/day for four consecutive days was given orally. A response was defined as an increase in the platelet count of at least 30,000/ՌL and a platelet count of more than 50,000/ՌL by day 10 after the initial treatment. A sustained response was defined as a platelet count of more than 50,000/ՌL that was maintained for six months after the initial treatment.
Results: Twenty two patients were eligible. The median platelet count before treatment was 19,000/ՌL. Seventeen patients (77%) among the 22 patients achieved an initial response by day 10: the mean platelet count 10 days after the initial treatment was 144,000/ՌL (range: 51,000 to 428,000/ՌL). Among the patients with a response, 4 (23.5%) had a sustained response, and the other 13 (76.5%) relapsed within six months. All the patients well tolerated the high-dose dexamethasone treatment.
Conclusion: A single course of high-dose dexamethasone is effective as an initial treatment for adults ITP patients, although the response duration is short. To maintain the response, repeated high-dose dexamethasone treatment may be needed or other alternative therapies can be considered.

Keywords Idiopathic thrombocytopenic purpura (ITP), Dexamethasone, Treatment

Article

Original Article

Korean J Hematol 2009; 44(1): 22-27

Published online March 30, 2009 https://doi.org/10.5045/kjh.2009.44.1.22

Copyright © The Korean Society of Hematology.

특발성 혈소판 감소성 자반증 환자의 초치료로서 고용량 덱사메타손 요법

윤진아 김찬규 김세형 김경하 김현정 박성규 이상철 이남수 배상병 이규택 원종호 박희숙 홍대식

순천향대학교 의과대학 내과학교실, 종양혈액내과학교실

Initial Therapy with High-Dose Dexamethasone for Patients with Idiopathic Thrombocytopenic Purpura

Jin Ah Yoon, Chan Kyu Kim, Se Hyung Kim, Kyung Ha Kim, Hyun Jung Kim, Sung Kyu Park, Sang Chul Lee, Nam Su Lee, Sang Byung Bae, Kyu Taek Lee, Jong Ho Won, Hee Sook Park, Dae Sik Hong

Department of Internal Medicine, Division of Hematology and Oncology, College of Medicine, Soonchunhyang University, Bucheon, Korea

Abstract

Background: Corticosteroids have been widely used for treatingidiopathic thrombocytopenic purpura (ITP) as a first-line treatment. Several different pulsed high-dose dexamethasone therapies for adult ITP have been reported on. We assessed the effectiveness of a single course of high dose dexamethasone as first-line treatment for adult patients with ITP.
Methods: The subjects of the study were previously untreated adult patients with newly diagnosed ITP and who had a platelet count of less than 20,000/ՌL or a platelet count less than 50,000/ՌL. High-dose dexamethasone at a dose of 40mg/day for four consecutive days was given orally. A response was defined as an increase in the platelet count of at least 30,000/ՌL and a platelet count of more than 50,000/ՌL by day 10 after the initial treatment. A sustained response was defined as a platelet count of more than 50,000/ՌL that was maintained for six months after the initial treatment.
Results: Twenty two patients were eligible. The median platelet count before treatment was 19,000/ՌL. Seventeen patients (77%) among the 22 patients achieved an initial response by day 10: the mean platelet count 10 days after the initial treatment was 144,000/ՌL (range: 51,000 to 428,000/ՌL). Among the patients with a response, 4 (23.5%) had a sustained response, and the other 13 (76.5%) relapsed within six months. All the patients well tolerated the high-dose dexamethasone treatment.
Conclusion: A single course of high-dose dexamethasone is effective as an initial treatment for adults ITP patients, although the response duration is short. To maintain the response, repeated high-dose dexamethasone treatment may be needed or other alternative therapies can be considered.

Keywords: Idiopathic thrombocytopenic purpura (ITP), Dexamethasone, Treatment

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