Cyclosporin A for the treatment of immune thrombocytopenic purpura

Objective:To observe the effects of cyclosporin A(CyA) on the treatment of immune thrombocytopenic purpura(ITP) patients who were refractory to corticosteroid or splenectomy and contraindicated to corticosteroid.Methods:Eleven patients were treated with cyclosporin A.Ten cases were diagnosed as ITP,and 4 of the 10 cases as Evan's syndrome because of complicating with autoimmune hemolytic anemia.One was diagnosed as secondary ITP because of ITP secondary to Sj ǒgren syndrome.Among the 11 cases,8 were refractory to and 2 contraindicated to corticosteroid,and all of them refused and cowld not accept splenectomy,and one was refractory to both corticosteroid and splenectomy.The initial dosage of CyA was 5mg/kg/d,and then it was adjusted according to blood concentrations of CyA which were maintained to the range of 200 ng～400 ng/ml.Blood routine,liver and renal function and blood pressure were monitored during the treatment.Results:All the 11 patients were responsive with 8 complete and 3 partial remission.Side effects were slight polytrichosis and hand tremor.No abnormal liver and renal functions and other side effects were found.Conclusion:CyA treatment is a new,effective and safe salvage therapy for refractory ITP,and can also be as a first choice of therapy for the ITP patients who were refractory to corticosteriod and refused or cowld not tolerate splenectomy.