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Blood, 15 February 2002, Vol. 99, No. 4, pp. 1482-1485
BRIEF REPORT
Long-term salvage therapy with cyclosporin A in refractory
idiopathic thrombocytopenic purpura
Giovanni Emilia,
Monica Morselli,
Mario Luppi,
Giuseppe Longo,
Roberto Marasca,
Giovanna Gandini,
Leonardo Ferrara,
Nicola D'Apollo,
Leonardo Potenza,
Marcello Bertesi, and
Giuseppe Torelli
From the Department of Medical Sciences, Section of
Internal Medicine and Hematology, University of Modena and Reggio
Emilia, Modena, Italy.
Treatment of severe, chronic idiopathic thrombocytopenic purpura
(ITP) refractory to most usual therapies is a difficult challenge. Little information exists on the clinical use of cyclosporin A (CyA) in
the treatment of ITP. This report describes long-term treatment with
CyA (median, 40 months) and follow-up (median, 36.8 months) in 12 adult
patients with resistant ITP. CyA used in relatively low doses (2.5-3 mg/kg of body weight per day) led to a clinical improvement in 10 patients (83.3%). Five had a complete response (41.1%), 4 a
complete response to maintenance therapy (33.3%), and one a partial
response (8.3%). Two patients had no response. Most patients with a
response (60%) had a long-term remission (mean, 28.6 months) after
discontinuation of CyA. One patient had a relapse of ITP 4 years after
CyA therapy was stopped. Side effects were moderate and transient, even
in patients dependent on continued CyA treatment. CyA seems to
represent reasonable salvage treatment in severe, potentially
life-threatening, refractory ITP.
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