Refractory ITP Treatment

Refractory ITP (immune thrombocytopenic purpura) is an autoimmune disorder lasting more than three months, which does not respond to splenectomy and results in low platelet counts. Available treatments work to increase blood platelets and reduce bruising or excessive bleeding.

Steroids

• The most common way to treat chronic refractory ITP is through low doses of steroids. Medications prescribed include corticosteroids, such as prednisone, danazol, dapsone and colchisine. Long-term steroid use is not recommended because of complications for patients with osteoporosis, cataracts and glaucoma.

Rituximab

• This medication, sometimes used as a chemotherapy agent, is commonly used in patients who don't respond to steroids. Ribuximab is an anti-CD20 monoclonal antibody, effective in treating non-Hodgkin's lymphoma, that targets the cells responsible for depleting blood platelets.

Aggressive Chemotherapy

• Patients who don't respond to previously mentioned therapies or who have severe bleeding may be subject to aggressive therapy, such as high-dose cyclophosphamide, given by injection into a vein. Combination therapies that include cyclophosphamide along with steroids and an additional chemotherapy agent may also be common.

Other Treatments

• Use of vinablastine (Velban) and gammaglobulin produce temporary increases in platelet counts. Vinablastine is considered only when most other therapies fail, while gammaglobulin is most often used in emergency situations.