Response to mercaptopurine for refractory autoimmune cytopenias in children.

Pediatric Blood & Cancer
Amy SobotaCarolyn M Bennett

Abstract

Several treatment strategies are available for children with severe immune thrombocytopenic purpura (ITP) and other immune cytopenias refractory to initial therapies. 6-Mercaptopurine (6MP) is one option, however it has not been well studied in children, especially as a single agent, and no pediatric case series have been reported since 1970. We reviewed the experience at our institution over 8 years, using 6MP as a steroid sparing treatment for children with ITP, auto-immune hemolytic anemia (AIHA) or Evans syndrome. A total of 29 pediatric patients were treated with 6MP from 2000 to 2007. Response was defined as a rise in hemoglobin by at least 1.5 g/dl and to a level of 10 g/dl or greater in patients treated for anemia, or a platelet count >or=50 x 10(9)/L in patients treated for thrombocytopenia. We found an overall response rate of 83% among all patients. Fourteen percent of patients stopped drug because of side effects. These results suggest that 6MP can be an effective single-agent treatment for refractory immune cytopenias in children. Prospective studies are warranted to determine long-term efficacy and toxicity and to more clearly define patient populations most likely to respond.

References

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Citations

May 19, 2010·Expert Review of Clinical Immunology·Martin BeneschJakob Passweg
Nov 19, 2013·Pediatric Clinics of North America·David T Teachey, Michele P Lambert
Nov 26, 2009·British Journal of Haematology·David T TeacheyStephan A Grupp
Sep 3, 2011·Blood·V Koneti Rao, João Bosco Oliveira
Apr 8, 2016·Blood·Adam Cuker, Cindy E Neunert
Jun 28, 2017·Journal of Pediatric Hematology/oncology·Elpis Mantadakis, Evangelia Farmaki
Dec 4, 2016·Hematology·Theodosia A Kalfa
Mar 5, 2019·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Anirban DasAmita Trehan

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