Anti-D treatment for pediatric immune thrombocytopenia: Is the bad reputation justified?

作者:Yacobovich Joanne*; Abu Ahmed Sabreen; Steinberg Shemer Orna; Goldberg Tracie; Cohen Miriam; Tamary Hannah
来源:Seminars in Hematology, 2016, 53(2): S64-S66.
DOI:10.1053/j.seminhematol.2016.04.019

摘要

The purpose of this study was to assess the efficacy and side effect profile of the repeated use of anti-D for the treatment of pediatric immune thrombocytopenia (ITP) in a large pediatric hematology center. We performed a retrospective analysis of patient records for children (aged 4 months-18 years) treated for ITP at Schneider Children's Medical Center of Israel from 1995-2015. Demographic and clinical data, reported adverse events, and therapy response were extracted from written and electronic files for all patients having received anti-D. Therapy response was defined as time to platelet count > 30 x 10(9)/L. Thirty-six patients received 170 treatments of anti-D at a dose of 75 mu g/kg. The majority were previously treated with corticosteroids and/or intravenous immunoglobulin (IVIG). Minimal adverse events were recorded including fever (3.5%), vomiting (2.9%), and headaches (1.7%). Notably only 1/170 treatments required blood transfusion and no life-threatening events occurred. The average time to platelets > 30 x 10(9)/L was 2.3 days, with a median of 1 day, range 1-12 days. Despite the reported severe adverse events in mainly elderly patients, the use of anti-D can be safe and effective in carefully chosen, low-risk pediatric patients with ITP.

  • 出版日期2016-4