A dose of 75 μg/kg/d of i.v. anti-D increases the platelet count more rapidly and for a longer period of time than 50 μg/kg/d in adults with immune thrombocytopenic purpura
Abstract
Treatment with 75 μg/kg/d intravenous (i.v.) anti-D was compared with 50 μg/kg/d in a prospective randomized study of 27 RhD-positive, human immunodeficiency virus-negative, adult, acute, non-splenectomized patients with immune thrombocytopenic purpura (ITP) and platelet counts ≤ 30 × 109/l. The higher dose resulted in greater median d 1 (43 × 109/l vs. 7·5 × 109/l; P = 0·012) and d 7 (153 × 109/l vs. 64·5 × 109/l; P = 0·001) platelet increases despite no greater haemoglobin decrease. Children with acute ITP receiving 75 μg/kg/d had overnight platelet increases in seven out of nine cases. The duration of effect at the 75 μg/kg/d dose was 46 d vs. 21 d (P = 0·03). Adverse events were mild to moderate and ameliorated with prednisone and acetaminophen premedication.
