[Treatment of immune thrombopenic purpura in adults. Current concepts]

Abstract

In immune thrombopenic purpura (ITP) therapy is aimed at achieving a safe blood platelet level, i.e. 50000/mm3. Platelet transfusions are helpful only in the case of serious bleeding. Corticosteroids are usually given first, but long-term efficiency can be expected in only one-third of patients. Splenectomy remains the best treatment, providing long-term remission in 50 to 85% of cases. Immunosuppressant therapy is used in intractable ITP; vinca alcaloids are the most effective agents. The value of plasma exchange, especially in cases of uncontrolled bleeding, and of high-dose intravenous gammaglobulin, is emphasized.