Intravenous Treatment with Gammaglobulin in Adults with Immune Thrombocytopenic Purpura: Review of the Literature1
- 1 April 1987
- journal article
- research article
- Published by Wiley in Vox Sanguinis
- Vol. 52 (3), 206-211
- https://doi.org/10.1111/j.1423-0410.1987.tb03029.x
Abstract
The results of high-dose intravenous gammaglobulin therapy (IVGG) of adults with immune thrombocytopenic purpura (ITP) were reviewed in 28 published reports which included 282 patients. Overall, 64% of the patients responded to IVGG with a peak platelet count greater than 100,000/mm3; 83% had peak platelet counts greater than 50,000/mm3. Unmodified immunoglobulin was superior to modified immunoglobulin; 70% of the patients treated with the former having platelet increases to greater than 100,000/mm3 compared to only 49% of those treated with the latter. More patients were refractory among those who had had ITP for at least 3 years. A higher peak platelet count immediately after IVGG administration was correlated with a longer duration of the platelet response. Patients above the age of 60 tended to have a weaker response to IVGG than did younger patients, and females tended to respond better than males. A pre-IVGG platelet count of less than 10,000/mm3 was not associated with a poor response to IVGG. While there is still no way to reliably predict response prior to therapy in an individual patient, the above information may help in the decision of whether or not treatment with IVGG is likely to be successful. It also suggests that inhibition of antiplatelet antibody production is an important mechanism of IVGG effect at least in some patients.Keywords
This publication has 28 references indexed in Scilit:
- Fc-depleted vs intact intravenous immunoglobulin in chronic ITPThe Journal of Pediatrics, 1984
- Intravenous use of gammaglobulin in the treatment of chronic immune thrombocytopenic purpura as a means to defer splenectomyThe Journal of Pediatrics, 1983
- High Dose Intravenous IgG Reduces Platelet Associated Immunoglobulins and Complement in Idiopathic Thrombocytopenic PurpuraScandinavian Journal of Haematology, 1983
- Treatment of Adult Autoimmune Thrombocytopenic Purpura with High-Dose Intravenous Plasmin-Cleaved GammaglobulinsScandinavian Journal of Haematology, 1983
- High-dose intravenous immunoglobulin therapy in patients with immune thrombocytopenic purpuraJAMA, 1983
- HIGH-DOSE INTRAVENOUS IgG IN ADULTS WITH AUTOIMMUNE THROMBOCYTOPENA.The Lancet, 1983
- Gamma Globulin for Idiopathic Thrombocytopenic PurpuraThe New England Journal of Medicine, 1982
- INCREASE-PLATELET-ASSOCIATED IgG IN PATIENT ON HIGH-DOSE GAMMAGLOBULIN FOR AUTOIMMUNE THROMBOCYTOPENIC PURPURAThe Lancet, 1982
- Transient Reversal of Thrombocytopenia in Idiopathic Thrombocytopenic Purpura by High-Dose Intravenous Gamma GlobulinThe New England Journal of Medicine, 1982
- HIGH-DOSE INTRAVENOUS GAMMAGLOBULIN FOR IDIOPATHIC THROMBOCYTOPENIC PURPURA IN CHILDHOODThe Lancet, 1981