Effect of Interferon(IFN) on Refractory Idiopathic Thrombocytopenic Purpura: Administration of 6 Million Units of Recombinant IFN alpha-2b.

Abstract

Five patients (six courses) with refractory idiopathic thrombocytopenic purpura (ITP) were given 6 million units of recombinant interferon (IFN) alpha-2b in 12 doses to achieve an improved response rate compared to previous studies using 3 million units. From the initial IFN administration, the platelet count increased from a pre-treatment level of 20.7 ± 17.7 X 103/ul (mean ± SD) and reached its first peak in weeks 2 or 3 of therapy (p<0.05). In week 5, the platelet count made its second and maximum peak (66.5 ± 57.9 X 103/^l; p < 0.05). A relatively good response of the platelet count (an increase to >50 X 103/ul) was observed in three patients (four courses) out of five. These responses were not much faster or more improved than in previous reports, and a dose of 6 million units may be too large to treat some ITP patients. The platelet-associated IgG level showed a tendency to be reduced with IFN therapy. The mechanism for the increase of the platelet count may be the modification of platelet autoantibody production.

Interferon‐alpha therapy in idiopathic thrombocytopenic purpura

“…Increased platelet response was transient in the five patients displaying improvement. 10 Dubbeld et al treated 21 patients with refractory ITP and concluded results similar to the case reports previously discussed. Two patients showed complete response after 4 weeks of therapy that lasted up to 7 months and subsequently resulted in relapse.…”

“…Two patients improved, one patient experienced slight improvement, and one patient became worse. Increased platelet response was transient in the five patients displaying improvement 10 …”

“…Up to 30% of patients with ITP are regarded as refractory to standard therapy 2 . Recently, it has been suggested that IFN‐α 2b may be useful in the treatment of both refractory ITP cases and selective ITP cases who has infected HIV infection 7–14 …”

“…2 Recently, it has been suggested that IFN-α 2b may be useful in the treatment of both refractory ITP cases and selective ITP cases who has infected HIV infection. [7][8][9][10][11][12][13][14] The role of INF-α in the treatment of ITP has not been well documented. One small clinical trial indicated that 84.6% of patients failing to respond to corticosteroid therapy and splenectomy might respond to INF-α.…”

Immunomodulatory treatments for persistent and chronic immune thrombocytopenic purpura

“…Eight studies investigated interferon alpha (22–29), and these included 83 patients (mean age 54 years, female 59%) were included. Three million units were administered subcutaneously 3 times weekly during 4 to 12 weeks except in 2 studies [ 24 , 26 ] (Table 2 ).…”