Treatment of idiopathic thrombocytopenic purpura (ITP): results of a multicentric protocol.

The results of a multicentric therapy protocol for Idiopathic Thrombocytopenic Purpura (ITP) in previously untreated patients are reported. Two different regimens of prednisone (A1: 0.5 mg/kg/day; A2: 1.5 mg/kg/day) were used in the induction phase. One hundred thirty patients (69 adults, 61 children), with a follow-up of almost 6 months, were evaluated. In adults good response to induction therapy was obtained in 30% of patients on schedule A1 and in 34% on schedule A2. In children good response was reached in 62% of cases with schedule A1 and in 81% with schedule A2. The difference in response to induction therapy in children vs. adults is statistically significant (p<0.001), whether the two schedules are considered separately or evaluated together. Anti-platelet, anti-nuclear, anti-smooth muscle, anti-mitochondrial, anti-viral and anti-toxoplasma antibodies were also determined at onset of the disease and after induction treatment. Thirty-two patients (25 adults and 7 children) with refractory ITP were splenectomized, twenty-six of whom had been previously studied for platelet survival and kinetics.