The Efficacy of High Dose Dexamethasone Therapy in Children with Immune Thrombocytopenic Purpura.
10.15264/cpho.2018.25.2.102
- Author:
Hyun Ok LEE
1
;
Seong Hwan CHANG
;
Hee Jo BAEK
;
Ho Sung KIM
;
Su Min PARK
;
Myung Geun SHIN
;
Hoon KOOK
Author Information
1. Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea. swan93@naver.com
- Publication Type:Original Article
- Keywords:
Immune thrombocytopenic purpura;
High dose dexamethasone
- MeSH:
Child*;
Dexamethasone*;
Fatigue;
Female;
Humans;
Medical Records;
Purpura, Thrombocytopenic, Idiopathic*;
Retrospective Studies
- From:Clinical Pediatric Hematology-Oncology
2018;25(2):102-107
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Few studies of high dose dexamethasone (HD-DXM) therapy in children with immune thrombocytopenic purpura (ITP) have been reported. The purpose of this study is to investigate efficacy and safety of repeated HD-DXM therapy as second-line treatment of ITP in childhood. METHODS: We retrospectively analyzed the medical records of patients < 18 years of age with primary ITP who received more than 2 cycles of HD-DXM therapy from May 2004 to January 2018. HD-DXM was given orally in 4-day pulses every 28 days as a 20–40 mg/1.73 m² daily dose. RESULTS: A total of 26 patients (male, 19; female, 7) were enrolled and their median age was 6 years (range, 1–15). All patients had received previous treatment for ITP. A median 6 cycles (range, 2–19) of HD-DXM was given. On the beginning of HD-DXM therapy, three patients satisfied the criteria for newly diagnosed ITP, 16 for persistent ITP and 7 for chronic ITP. Relapse-free survival (RFS) of responders (n=9) after the last HD-DXM cycle was estimated to be 38.1±17.2%, lasting for a median 9.1 months (range, 5.6–46.2). According to response after the 2nd cycle, RFS of responders (n=13) was significantly higher than non-responders (23.1±11.7% vs. 7.7%±7.4%, P=0.001). The most common adverse event was irritability (30.8%), followed by fatigue (19.2%). CONCLUSION: HD-DXM therapy in children was relatively tolerated and response after therapy was acceptable. More courses of HD-DXM may be feasible in responders after two cycles of HD-DXM.
