Vincristine Effect for the Treatment of Idiopathic Thrombocytopenic Purpura in Childhood

Hong, Chang Hee; Park, Ji Kyoung; Lee, Soon Yong

Abstract

PURPOSE: The aim of this study was to evaluate the effect of vincristine for the patients with idiopathic thrombocytopenic purpura (ITP), who were resistant to both intravenous methylprednisolone (IVMP) and intravenous immunoglobulin (IVIG).
METHODS
We retrospectively analyzed nine children with ITP who were treated with vincristine at Busan Paik Hospital from January, 1999 to December, 2006. All were refractory to the treatment with IVMP and IVIG. Vincristine was administered with the dose of 0.02 mg/kg, once a week, at least three times. The results were classified into complete response (CR: platelet count > or =100,000/mm3), partial response (PR: 50,000/mm3 < or = platelet count <100,000/mm3) and no response (NR: platelet count <50,000/mm3).
RESULTS
There were 6 boys and 3 girls among the total 9 patients. It took an average of 3.3 months (0.3 months~14 months) from initial diagnosis of ITP until the first administration of vincristine. Vincristine was administrated in average 4 times (3~8 times) with the dose of 0.02 mg/kg to the 9 patients. Of the 9 patients, 4 patients showed complete response (44.4%), one showed partial response (11.2%) and remaining 4 showed no response (44.4%). 5) There was only one patient who complained of oral discomfort as a side-effect of vincristine.
CONCLUSION
We concluded that vincristine could be a beneficial and safe treatment strategy for patients with ITP, resistant to both IVMP and IVIG, especially for the chronic ITP patients before considering splenectomy.