Long-Term Outcomes after Treatment for Refractory Immune Thrombocytopenic Purpura

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Abstract
In April 1993, my colleagues and I reported in the Journal our experience with combination chemotherapy as a treatment for patients with severe refractory immune thrombocytopenic purpura.1 We now provide long-term follow-up data on the initial eight patients with immune thrombocytopenic purpura and on four additional patients ( Table 1 ). All patients had severe disease with periodic mucosal bleeding, and in all splenectomy had failed, as had an average of five other therapies. Of the 12 patients treated, 5 had a complete remission (a normal platelet count) and 1 had a partial remission (a platelet count of more than 50,000 per microliter); these remissions persisted without further therapy until the last follow-up visit or until their death from another cause (a cerebrovascular accident in Patient 5 and fulminant hepatitis C acquired from a transfusion in Patient 6). Remissions in the four surviving patients have lasted from more than 60 to more than 150 months.

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