TY - JOUR
T1 - Anti-D treatment for pediatric immune thrombocytopenia
T2 - Is the bad reputation justified?
AU - Yacobovich, Joanne
AU - Abu-Ahmed, Sabreen
AU - Steinberg-Shemer, Orna
AU - Goldberg, Tracie
AU - Cohen, Miriam
AU - Tamary, Hannah
N1 - Publisher Copyright:
© 2016 Elsevier Inc..
PY - 2016/4/1
Y1 - 2016/4/1
N2 - The purpose of this study was to assess the efficacy and side effect profile of the repeated use of anti-D for the treatment of pediatric immune thrombocytopenia (ITP) in a large pediatric hematology center. We performed a retrospective analysis of patient records for children (aged 4 months-18 years) treated for ITP at Schneider Children's Medical Center of Israel from 1995-2015. Demographic and clinical data, reported adverse events, and therapy response were extracted from written and electronic files for all patients having received anti-D. Therapy response was defined as time to platelet count >30 x 109/L. Thirty-six patients received 170 treatments of anti-D at a dose of 75 μg/kg. The majority were previously treated with corticosteroids and/or intravenous immunoglobulin (IVIG). Minimal adverse events were recorded including fever (3.5%), vomiting (2.9%), and headaches (1.7%). Notably only 1/170 treatments required blood transfusion and no life-threatening events occurred. The average time to platelets >30 x 109/L was 2.3 days, with a median of 1 day, range 1-12 days. Despite the reported severe adverse events in mainly elderly patients, the use of anti-D can be safe and effective in carefully chosen, low-risk pediatric patients with ITP.
AB - The purpose of this study was to assess the efficacy and side effect profile of the repeated use of anti-D for the treatment of pediatric immune thrombocytopenia (ITP) in a large pediatric hematology center. We performed a retrospective analysis of patient records for children (aged 4 months-18 years) treated for ITP at Schneider Children's Medical Center of Israel from 1995-2015. Demographic and clinical data, reported adverse events, and therapy response were extracted from written and electronic files for all patients having received anti-D. Therapy response was defined as time to platelet count >30 x 109/L. Thirty-six patients received 170 treatments of anti-D at a dose of 75 μg/kg. The majority were previously treated with corticosteroids and/or intravenous immunoglobulin (IVIG). Minimal adverse events were recorded including fever (3.5%), vomiting (2.9%), and headaches (1.7%). Notably only 1/170 treatments required blood transfusion and no life-threatening events occurred. The average time to platelets >30 x 109/L was 2.3 days, with a median of 1 day, range 1-12 days. Despite the reported severe adverse events in mainly elderly patients, the use of anti-D can be safe and effective in carefully chosen, low-risk pediatric patients with ITP.
KW - Anti-D
KW - Immune thrombocytopenia
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=84973911000&partnerID=8YFLogxK
U2 - 10.1053/j.seminhematol.2016.04.019
DO - 10.1053/j.seminhematol.2016.04.019
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C2 - 27312170
AN - SCOPUS:84973911000
SN - 0037-1963
VL - 53
SP - S64-S66
JO - Seminars in Hematology
JF - Seminars in Hematology
M1 - 50869
ER -