PULSED HIGH-DOSE DEXAMETHASONE THERAPY IN CHILDREN WITH CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

Purpose: The effectiveness of pulsed high-dose oral dexamethasone ther apy in children with refractory chronic idiopathic thrombocytopenic pu rpura (ITP) is evaluated. Patients and Methods: Seven children (5 to 1 6 years old) who were refractory to 2 to 5 conventional standard thera pies were included in the study. Dexamethasone was administered orally at a dosage of 40 mg/m(2) per day (maximum 40 mg/day) for 4 consecuti ve days as a cycle. The cycle was repeated once a month for 6 months. Results: One month after the first cycle, partial responses of platele t counts (greater than or equal to 50x10(9)/L and <150x10(9)/L) were o bserved in three patients (43%). At the end of the sixth cycle, two pa tients (29%) had complete responses (>150x10(9)/L) and one had a parti al response. However, only one patient (14%) remained partially respon sive 1 year after completion of therapy.Conclusions: In contrast to wh at was observed in adults, this preliminary study suggests that pulsed high-dose oral dexamethasone therapy was not uniformly effective in c hildren with chronic ITP.