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Blood, 15 February 2007, Vol. 109, No. 4, pp. 1401-1407. Prepublished online as a Blood First Edition Paper on October 31, 2006; DOI 10.1182/blood-2005-12-015222. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2005-12-015222v1 109/4/1401    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mazzucconi, M. G. Articles by Mandelli, F. Search for Related Content PubMed PubMed Citation Articles by Mazzucconi, M. G. Articles by Mandelli, F. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted December 30, 2005 Accepted August 22, 2006 Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura. A GIMEMA experience Maria Gabriella Mazzucconi*, Paola Fazi, Sayla Bernasconi, Giulio De Rossi, Giuseppe Leone, Luigi Gugliotta, Nicola Vianelli, Giuseppe Avvisati, Francesco Rodeghiero, Angela Amendola, Carlo Baronci, Cecilia Carbone, Stefano Quattrin, Giuseppe Fioritoni, Giulio D'Alfonso, and Franco Mandelli Universita degli Studi di Roma "La Sapienza", Italy Fondazione GIMEMA, Italy Ospedale pediatrico Bambino Gesu, Italy Universita Cattolica del Sacro Cuore, Italy Arciospedale "Santa Maria Nuova", Italy Universita di Bologna, Italy Libera Universita "Campus Bio-Medico", Italy Ospedale "S. Bortolo", Italy Ospedali Civili, Italy Ospedale "S. Maria delle Grazie", Italy Azienda USL, Italy * Corresponding author; email: mazzucconi{at}bce.uniroma1.it. In Idiopathic Thrombocytopenic Purpura (ITP) corticosteroids have been widely recognized as the most appropriate first-line treatment, even if the best therapeutic approach is still a matter of debate. Recently, a single HD-DXM course was administered as first-line therapy in adult ITP patients. In this paper we show the results of two prospective pilot studies (monocentric and a multicentric, respectively) concerning the use of repeated pulses of HD-DXM in untreated ITP patients. Monocentre study: 37 severe ITP patients, age 20 and 65, were enrolled. HD-DXM, in 4 day pulses, every 28 days, for 6 cycles was given. Response rate was 89.2%; relapse free survival (RFS) 90% at 15 months; long-term responses, lasting for a median time of 26 months (6-77), were 25/37 (67.6%). Multicentre study: 95 severe ITP patients, age 2 and 70, were enrolled HD-DXM in 4 days pulses, every 14 days, for 4 cycles was given, 90 completed 4 cycles. Response rate (85.6%) was similar in patients classified by age (<18 years, 36/42= 85.7%; 18 years, 41/48= 85.4%, p=n.s.), with a statistically significant difference between the second and third cycle (75.8% vs 89%, p=0.018). RFS at 15 months 81%; long-term responses, lasting for a median time of 8 months (4-24), were 67/90 (74.4%). In both studies, therapy was well tolerated. A schedule of three cycles of HD-DXM pulses will be compared with standard prednisone therapy (e.g.1mg/Kg/day) in a next randomized GIMEMA trial. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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