Experience with protein A-immunoadsorption in treatment-resistant adult immune thrombocytopenic purpura.
In: Blood, Jg. 79 (1992-05-01), Heft 9, S. 2237
academicJournal
Zugriff:
Extracorporeal immunoadsorption of plasma to remove IgG and circulating immune complexes (CIC) was evaluated as a therapy for adults with treatment-resistant immune thrombocytopenic purpura (ITP). Seventy-two patients with initial platelet counts less than 50,000/microL who had failed at least two other therapies were studied. They received an average of six treatments of 0.25 to 2.0 L plasma per procedure over a 2- to 3-week period using columns of staphylococcal protein A-silica (PROSORBA immunoadsorption treatment columns; IMRE Corp, Seattle, WA). The treatments caused an acute increase in the platelet count to greater than 100,000/microL in 18 patients and to 50,000 to 100,000/microL in 15 patients. The median time to response was 2 weeks. Responses were transient (less than 1 month duration) in seven of those patients (10%), but no additional relapses were reported over a follow-up period of up to 26 months (mean of 8 months). Clinical responses were associated with significant decreases in specific serum platelet autoantibodies (including anti-glycoprotein IIb/IIIa), platelet-associated Ig, and CIC. Thirty percent of treatments were associated with transient mild to moderate side effects usually presenting as a hypersensitivity-type reaction. Continued administration of failed therapies for ITP, which always included low-dose corticosteroids (less than or equal to 30 mg/d), had no demonstrable influence on the effectiveness of immunoadsorption treatment but did depress the incidence and severity of side effects. The degree of effectiveness of protein A immunoadsorption therapy in patients with treatment-resistant ITP is promising and further controlled studies in this patient population are warranted.
Titel: |
Experience with protein A-immunoadsorption in treatment-resistant adult immune thrombocytopenic purpura.
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Autor/in / Beteiligte Person: | Snyder HW Jr ; Cochran, SK ; Balint JP Jr ; Bertram, JH ; Mittelman, A ; Guthrie TH Jr ; Jones, FR |
Zeitschrift: | Blood, Jg. 79 (1992-05-01), Heft 9, S. 2237 |
Veröffentlichung: | 2021- : [New York] : Elsevier ; <i>Original Publication</i>: New York, Grune & Stratton [etc.], 1992 |
Medientyp: | academicJournal |
ISSN: | 0006-4971 (print) |
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