Characteristics of the treatments used in adult chronic immune thrombocytopenic purpura (ITP).
| Therapy . | Dose . | Response Time . | Common Side Effects . |
|---|---|---|---|
| * Acute leukemia or myelodysplasia have resulted from therapy with alkylating agents. | |||
| † Lymphoproliferative disorders or acute leukemia have occurred in patients with other disorders receiving these drugs. | |||
| # Several combinations have been used.27 | |||
| Abbreviations: PO, by mouth; IV, intravenous; SC, subcutaneously; qd, daily; bid, 2 times daily; tid, 3 times daily; qid, 4 times daily; GI, gastrointestinal | |||
| Prednisone | 1.0 mg/kg PO qd | 1–4 weeks | Hypokalemia, gastric upset, sodium and fluid retention, hyperglycemia, hypertension, myopathy, osteoporosis, infection risk, psychosis. |
| Colchicine | 0.6 mg PO tid | 4–8 weeks | Diarrhea (may limit therapy), nausea, vomiting. |
| Dapsone | 75–100 mg PO qd | 4–8 weeks | Hemolysis, agranulocytosis, aplastic anemia, exfoliative dermatitis, toxic hepatitis, choleostatic jaundice, peripheral neuropathy. |
| Danazol | 200 mg PO qid | 3–6 months | Weight gain, fluid retention, seborrhea, hirsutism, vocal changes, amenorrhea, acne, headache, liver toxicity. |
| Rituximab | 375 mg/M2 IV q week × 4 | 3–4 weeks | Infusional symptoms: (fever, chills, headache, broncho- spasm), severe B cell reduction and potential for infection. |
| Cyclophosphamide | 150 mg PO qd | 6–8 weeks | Cytopenias, hemorrhagic cystitis, GI symptoms, sterility, secondary malignancies.* |
| Azathioprine | 150 mg PO qd | 2–10 months | Cytopenias, GI symptoms, secondary malignancies.† |
| Cyclosporine | 1.25–2.5 mg/kg PO bid | Variable | Renal insufficiency, hepatotoxicity, hypertension, tremor, hirsutism, gum hyperplasia, hypomagnesemia, secondary malignancies.† |
| Mycophenolate mofetil | 0.5–1.0 g BID PO | 3–4 weeks | Diarrhea, leukopenia, headache, secondary malignancies.† |
| High-dose cyclophosphamide | 1.0–1.5 g/M2 IV q 4 weeks | 1–4 weeks | Cytopenias, hemorrhagic cystitis, GI symptoms, alopecia, sterility, myocardiopathy, secondary malignancies.* |
| Combination chemotherapy | See below# | 1–4 weeks | Cytopenias, hemorrhagic cystitis, alopecia, dermatitis, anaphylaxis, GI symptoms, sterility, myocardiopathy, mucositis, secondary malignancies.* |
| Therapy . | Dose . | Response Time . | Common Side Effects . |
|---|---|---|---|
| * Acute leukemia or myelodysplasia have resulted from therapy with alkylating agents. | |||
| † Lymphoproliferative disorders or acute leukemia have occurred in patients with other disorders receiving these drugs. | |||
| # Several combinations have been used.27 | |||
| Abbreviations: PO, by mouth; IV, intravenous; SC, subcutaneously; qd, daily; bid, 2 times daily; tid, 3 times daily; qid, 4 times daily; GI, gastrointestinal | |||
| Prednisone | 1.0 mg/kg PO qd | 1–4 weeks | Hypokalemia, gastric upset, sodium and fluid retention, hyperglycemia, hypertension, myopathy, osteoporosis, infection risk, psychosis. |
| Colchicine | 0.6 mg PO tid | 4–8 weeks | Diarrhea (may limit therapy), nausea, vomiting. |
| Dapsone | 75–100 mg PO qd | 4–8 weeks | Hemolysis, agranulocytosis, aplastic anemia, exfoliative dermatitis, toxic hepatitis, choleostatic jaundice, peripheral neuropathy. |
| Danazol | 200 mg PO qid | 3–6 months | Weight gain, fluid retention, seborrhea, hirsutism, vocal changes, amenorrhea, acne, headache, liver toxicity. |
| Rituximab | 375 mg/M2 IV q week × 4 | 3–4 weeks | Infusional symptoms: (fever, chills, headache, broncho- spasm), severe B cell reduction and potential for infection. |
| Cyclophosphamide | 150 mg PO qd | 6–8 weeks | Cytopenias, hemorrhagic cystitis, GI symptoms, sterility, secondary malignancies.* |
| Azathioprine | 150 mg PO qd | 2–10 months | Cytopenias, GI symptoms, secondary malignancies.† |
| Cyclosporine | 1.25–2.5 mg/kg PO bid | Variable | Renal insufficiency, hepatotoxicity, hypertension, tremor, hirsutism, gum hyperplasia, hypomagnesemia, secondary malignancies.† |
| Mycophenolate mofetil | 0.5–1.0 g BID PO | 3–4 weeks | Diarrhea, leukopenia, headache, secondary malignancies.† |
| High-dose cyclophosphamide | 1.0–1.5 g/M2 IV q 4 weeks | 1–4 weeks | Cytopenias, hemorrhagic cystitis, GI symptoms, alopecia, sterility, myocardiopathy, secondary malignancies.* |
| Combination chemotherapy | See below# | 1–4 weeks | Cytopenias, hemorrhagic cystitis, alopecia, dermatitis, anaphylaxis, GI symptoms, sterility, myocardiopathy, mucositis, secondary malignancies.* |