6-Mercaptopurine Fails to Improve Platelet Count in Pediatric Chronic Immune Thrombocytopenia
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Majority of children with chronic immune thrombocytopenia (ITP) have a benign course. Disease-modifying therapy using dexamethasone, rituximab, TPO-agonists, or splenectomy, each with long-term adverse effects and financial implications, is restricted for those with significant or troublesome bleeds [1, 2]. The index study aimed to evaluate response to 6-mercaptopurine (6MP) in children with chronic ITP, based on previous report of successful use . Successive children with chronic ITP having: (a) recurrent, troublesome skin/subcutaneous/mucosal bleeds (grade 2/3), (b) no sustained response to corticosteroids, and, (c) negative HIV and ANA titers, were enrolled between July and December 2010, and prospectively started on 6MP at a dose of 50 mg/m2/day for 4-months. Pre-treatment platelet counts were compared to counts at 1, 2, 3, 4 and 6-months after staring 6MP. Complete response was defined as an increase to > 100 × 109/L, and a clinically relevant response as increase...
AT: planned the study. AD: collected and analysed the data, and prepared the manuscript. PB: reported the hematology.
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Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval was duly obtained for this study.
Informed consent was duly obtained for this study.
- 2.Neunert CE, Buchanan GR, Imbach P, Intercontinental Cooperative ITP Study Group Registry II Participants et al (2013) Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: data from the Intercontinental Cooperative ITP Study Group (ICIS). Blood 121:4457–4462CrossRefGoogle Scholar