Treatment of Chronic Idiopathic Thrombocytopenic Purpura in Children with Cepharanthin (R) / 대한소아혈액종양학회지

ABSTRACT

PURPOSE: Cepharanthin (R) has been reported to improve the symptoms of intractable or steroid-resistant chronic idiopathic thrombocytopenic purpura (ITP). We report the clinical efficacy of oral high dose Cepharanthin (R) in refractory chronic ITP. METHODS: We analyzed eleven patients who were diagnosed as chronic ITP at the Department of Pediatrics, Seoul National University Hospital from January, 2002 to February, 2004. After informed consent patients with platelet count below 20, 000/mm3 were treated with Cepharanthin (R) at the initial dose of 5 gm/day. The doses were increased up to 15 gm/day if there was no response. For the purposes of this study, complete remission was defined as an elevation of the platelet count > or =50, 000/mm3 from the baseline after 4 weeks of treatment. Partial remission was defined as an elevation of the platelet count 20, 000/mm3 and < = or50, 000/mm3 from the baseline. RESULTS: Seven boys and four girls with a median age of 10 were enrolled. Two to four weeks after the initiation of this therapy, 4 patients showed their platelet counts over 50, 000/mm3 1 patients reached partial remission state, 6 patients had no response. Side effects of Cepharanthin (R) were not observed in all patients. CONCLUSION: We suggest that the oral administration of Cepharanthin (R) could be a beneficial and a safe treatment strategy for the refractory chronic ITP patients. Further studies should be performed to elucidate the mechanism of responses.