Recombinant human thrombopoietin in combination with cyclosporin A as a novel therapy in corticosteroid-resistant primary immune thrombocytopenia
Recombinant human thrombopoietin in combination with cyclosporin A as a novel therapy in corticosteroid-resistant primary immune thrombocytopenia
复制标题
DOI：
10.3760/cma.j.issn.0366-6999.20131116
复制
发表时间：
2013-11-05
影响因子：
6.1
通讯作者：
Zhao Chun-ting
中科院分区：
文献类型：
--
作者：
Cui Zhong-guang;Liu Xin-guang;Zhao Chun-ting
背景：难治性免疫性血小板减少症(ITP)患者的治疗具有挑战性，因为没有标准的治疗方案。目的探讨重组人血小板生成素(RhTPO)联合环孢素A(CsA)治疗糖皮质激素耐药的原发性特发性血小板减少性紫杉醇(ITP)的疗效。观察组19例，给予重组人血小板生成素1 mg/kg(300U/kg)皮下注射，每日1次，至第14天；同时口服环孢素A 1.5~2.0 mg/kg，每日2次，疗程3个月。结果治疗开始后第1周末，观察组与对照组的有效率分别为63.2%和58.8%(P&gT；0.05)，第2周末的有效率分别为89.5%和94.1%(P&gT；0.05)。治疗结束时观察组复发率为17.7%，明显低于对照组的50.0%(P
Background The management of patients with refractory immune thrombocytopenia (ITP) is challenging, as there is no standard treatment option. The aim of this study was to investigate the efficacy of recombinant human thrombopoietin (rhTPO) in combination with cyclosporin A (CsA) for the management of patients with corticosteroid-resistant primary ITP.Methods Thirty-six patients with corticosteroid-resistant ITP were randomly divided into an observation group and control group. In the observation group, 19 patients received subcutaneous injection of rhTPO at a dose of 1 mu g/kg (300 U/kg) once daily up to day 14. Simultaneously they also received oral CsA at a dose of 1.5-2.0 mg/kg twice daily for three months. In the control group, rhTPO alone was administered subcutaneously at 1 mu g/kg once daily in the other 17 ITP patients for 14 consecutive days and then the treatment was withdrawn.Results There was no significant difference in the response rate at the end of the first week after treatment initiation between the observation group and the control group (63.2% vs. 58.8%, P >0.05), neither was there at the end of the second week (89.5% vs. 94.1%, P >0.05). However, the relapse rate in the observation group was significantly lower than that in control group at the end of the first (17.7% vs. 50.0%, P