LONG-TERM USE OF ANTI-D IN CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

Chronic idiopathic thrombocytopenic purpura is an autoimmune disease c haracterized by antibody-mediated destruction of platelets. To maintai n the platelets above the symptomatic level, we administered anti-D (1 00 mu g for 5 consecutive days) in 19 children with idiopathic thrombo cytopenic purpura (ITP). Four patients did not respond to treatment. F ifteen responded with an increase in the average platelet number to 76 ,000 / mu L on the 7(th) postinjection day. Within 45 days, however, p latelets dropped to 27,000 / mu L. Three months after this study, two patients from the study group were re-administered anti-D in daily inj ections for 5 consecutive days, as was done previously. Monthly admini stration of anti-D in two patients maintained platelets above 30,000 / mu L for periods of five and six months. We concluded that monthly ad ministration of anti-D after five consecutive daily injections can mai ntain platelet levels above the symptomatic level and may provide a co rticosteroid-free safe interval of nearly five months.