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Multicenter Study
. 2015 Nov;171(4):625-30.
doi: 10.1111/bjh.13622. Epub 2015 Aug 6.

Mycophenolate Mofetil Therapy for Severe Immune Thrombocytopenia

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Multicenter Study

Mycophenolate Mofetil Therapy for Severe Immune Thrombocytopenia

Alice Taylor et al. Br J Haematol. .

Abstract

Severe immune thrombocytopenia purpura (ITP) presents a clinical challenge. Second-line treatment options are variable without a precise protocol. We present 46 severe ITP patients treated with mycophenolate mofetil (MMF), retrospectively identified from three London teaching hospitals. Data was collected on patient demographics, co-morbidities and previous treatment strategies. Our key interest was whether there was a sustained response in platelet count to MMF. Patients included 27 males and 19 females whose ages ranged from 19 to 93 years old (median 52·5 years). Twenty-nine had primary ITP and 17 had secondary ITP, a third of whom had viral-associated disease. The standard dose of MMF was 1 g/day. Twenty-four patients (52%) responded with 15 (33%) achieving a complete response. No active viral-associated ITP patients demonstrated a response to MMF, although numbers were small (n = 4). We were not able to demonstrate a difference between responders and non-responders based on gender, age, previous therapies or time since diagnosis of ITP. Three of four previously splenectomized patients responded, two achieving complete response. We conclude that MMF is a useful steroid-sparing immunosuppressant to be considered in the second-line or later treatment of ITP.

Keywords: immune thrombocytopenia purpura; mycophenolate mofetil; platelets.

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