High-dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan.
High-dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan.
复制标题
高剂量千金藤素在日本治疗儿童慢性免疫性血小板减少症。
DOI：
10.1111/ped.13151
复制
发表时间：
2017
期刊：
影响因子：
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通讯作者：
Amemiya S.
中科院分区：
文献类型：
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作者：
Yamazaki T;Shibuya A;Ishii S;Miura N;Ohtake A;Sasaki N;Araki R;Ota Y;Fujiwara M;Miyajima Y;Uetake K;Hamahata K;Kato K;Kawakami K;Toyoda H;Moriguchi N;Okada M;Nishi M;Ogata Y;Takimoto T;Ohga S;Ohta S;Amemiya S.
为评价头孢菌素(CEP)治疗儿童慢性免疫性血小板减少症(ITP)的临床疗效，开展了一项全国性、多中心、观察性研究。方法分析2001-2011年在14家医院确诊为慢性ITP的46例日本患者的临床和实验室资料，CEP治疗12个月。治疗12个月和24个月时，血小板计数中位数分别为58.5×10~9/L和69.0×10~9/L。没有危及生命的出血或中-重度不良事件的报告。在38例同时接受皮质类固醇(CS)和CEP治疗的患者中，17例(45%)脱离了CS，15例(39%)获得了减少剂量的CS。从CEP开始到CS停药的时间中位数为413天(49~1734天)。结论CEP或与CS联合应用是治疗儿童慢性ITP的有效方法。
BackgroundA nationwide, multicenter and observational study was retrospectively conducted to evaluate the clinical utility of Cepharanthin (CEP) for pediatric patients with chronic immune thrombocytopenia (ITP).MethodsClinical and laboratory data for 46 Japanese patients aged <16 years who were diagnosed as having chronic ITP in 14 hospitals during 2001–2011, and were treated with CEP for >12 months, were analyzed.ResultsMedian daily CEP dose was 1 mg/kg (range, 0.12–2 mg/kg). Median platelet count prior to CEP was 20.5 × 109/L (IQR, 8.3–53.0 × 109/L), and then significantly increased to 58.5 × 109/L (IQR, 22.8–115.0 × 109/L) and 69.0 × 109/L (IQR, 23.0–134.0 × 109/L) at 12 and 24 months of treatment, respectively. No life‐threatening bleeds or moderate–severe adverse events were reported. Of 38 patients who received both corticosteroids (CS) and CEP, 17 patients (45%) were weaned from CS, and 15 patients (39%) attained the reduced dose of CS. The duration from the start of CEP to the stopping of CS was a median of 413 days (range, 49–1734 days) in patients who were weaned from CS.ConclusionsCEP alone or combined with CS was useful for the management of pediatric chronic ITPs.