Treatment Synopsis

Below is a list of conventional treatments used for ITP.  Click on the name for more details.  In a few cases, other treatments have been used for ITP. Treatments are sometimes combined to increase effectiveness.  See our survey results for some treatment statistics.

We would like to thank Vick, one of our volunteers for compiling the detail treatment descriptions.

Treatments (in alphabetical order)

Anti-D

Used to achieve a temporary elevation of the platelet count. It has the advantage over IVIg of being administered via injection rather than an IV infusion.

Chemotherapy

Various chemotherapy drugs have been used as an almost last resort for chronic ITP patients. Vincristine and Cytoxan (cyclophosphamide) are the ones that are most frequently prescribed. Each has a slightly different profile of side effects. They include hair loss, decreased immunity, and damage to the central and peripheral nervous systems.

Danazol (danocrine)

This drug is also used to treat endometriosis. It is a synthetic androgen (male sex hormone) It disrupts the action of the pituitary gland and reduces estrogen, halts menses, and promotes the growth of facial hair and acne.

Decadron (dexamethasone)

A steroid, similar to prednisone in its effects on the body. It is often given in pulses, doses of a shorter duration that are repeated. Long term use can result in altered mood and personality, cataracts, glaucoma, hypertension, arrhythmias, peptic ulcers, pancreatitus, osteoporosis, and increased susceptibility to infections.

Imuran (azathioprine)

An anti-arthritic and immunosuppressive drug. It is also used to prevent the rejection of transplanted organs and in the treatment of rheumatoid arthritis and lupus. It can reduce the level of white blood cells, cause liver damage and increase the risk of malignancy.

IVIg

This is an intravenous infusion of immunoglobulin, a type of antibody.  The antibodies attach to the receptors in the spleen, sparing the removal of antibody coated platelets. This treatment is a temporary measure and is not expected to result in a sustained elevated platelet count, although in some rare cases this does happen. The side effects include allergic reactions and heart palpitations.

Prednisone

This steroid is often used in the treatment of allergies and other autoimmune diseases.  For ITP, typically the dose is initially quite high then gradually tapered. Sometimes the platelets remain elevated after the prednisone is tapered. In most cases the platelet count recedes as the prednisone is reduced.

The side effects can be uncomfortable and grow in severity if the treatment is continued for a long time. They often include weight gain, mood changes, elevated blood pressure, insomnia, blood sugar changes, calcium loss, muscle wasting, and increased susceptibility to infections.

Rituxan

This is a monoclonal antibody approved by the FDA to treat lymphoma. There has been some initial success in its use to treat ITP.  Clinical studies are in progress.

Sandimmune (cyclosporine)

Helps prevent the organ rejection in kidney, liver, and heart transplants by inhibiting some white blood cells and their growth factors. It can cause excessive hair growth, liver toxicity, a low white blood cell count, and lymphoma.

Splenectomy

This is a surgical procedure where the spleen is removed. The spleen acts like a giant lymph node. It plays a part in maintaining a healthy immune system and cleans the blood of foreign matter. It helps eliminate the platelets that have antibodies bound to them. Theoretically, if the spleen is removed, the platelets will stay.

The spleen can be removed via a large incision or by laproscopic surgery. Patients who have experienced the laproscopic technique report that they recovered more quickly and had smaller incisions over time.

A splenectomy does not always result in a sustained elevated platelet count. Read the journal article section for published statistics. Pay close attention to the success criteria.

After a splenectomy, the patients’ immune system is compromised. Immunizations are given before the operation and periodically after. Some hematologists suggest the patient take antibiotics as a preventative measure. Others do not.

Watchful Waiting

More of a strategy than a treatment, Watchful Waiting means choosing to live with your current, safe counts while carefully monitoring your disease and treatment options.