The use of vinca alkaloids in adult patients with refractory chronic idiopathic thrombocytopenia

Sikorska, A.; Słomkowski, M; Marlanka, K; Konopka, L; Górski, T

doi:10.1111/j.1365-2257.2004.00643.x

Cited by 25 publications

(21 citation statements)

References 12 publications

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“…Thus, rituximab would be preferred over splenectomy [9]. Vinca alkaloids have also been used as a second-line therapy in steroid-resistant ITP, with moderate success [11].…”

Section: Discussionmentioning

confidence: 99%

Resolution of Hypersplenism and Pancytopenia in Common Variable Immunodeficiency Patient After Partial Splenic Artery Embolization: A Case Report and Review of Literature

Sumayli¹,

Shekaili²,

Gazlan³

et al. 2015

J Hematol

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Common variable immunodeficiency (CVID) is the second most prevalent primary immunodeficiency disorder following selective immunoglobulin A (IgA) deficiency but it is more complicated clinically. It causes a wide spectrum of symptoms and signs affecting several systems of the body. CVID is mostly a humoral immunodeficiency with cell-mediated immunity being affected in some patients leading to both autoimmunity and malignancy adding to the immunodeficiency, which makes the management of these patients very complicated. Gastrointestinal tract (GIT) and bone marrow are commonly affected organs by both autoimmunity and malignancy in the context of CVID. In this paper, we present a case of CVID who presented with pancytopenia secondary to hypersplenism and failed both intravenous immunoglobulins (IVIG) and steroids treatment. She underwent partial splenic artery embolization as an alternative procedure to total splenectomy to preserve some splenic function and avoid surgical total splenectomy. Partial splenic artery embolization leads to dramatic improvement in platelets, hemoglobin and white cell count after the procedure without further compromising her immune system.

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“…Thus, rituximab would be preferred over splenectomy [9]. Vinca alkaloids have also been used as a second-line therapy in steroid-resistant ITP, with moderate success [11].…”

Section: Discussionmentioning

confidence: 99%

Resolution of Hypersplenism and Pancytopenia in Common Variable Immunodeficiency Patient After Partial Splenic Artery Embolization: A Case Report and Review of Literature

Sumayli¹,

Shekaili²,

Gazlan³

et al. 2015

J Hematol

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“…Studies that included more than 10 patients are reported in Table 3 [62][63][64][65][66]. The efficacy of vinca-alkaloids seems to be higher in newly diagnosed ITP than in persistent and chronic ITP.…”

Section: Vinca-alkaloids: Vincristine Vinblastinementioning

confidence: 97%

Is there still a place for “old therapies” in the management of immune thrombocytopenia?

Audia

Godeau

Bonnotte

2016

La Revue de Médecine Interne

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New molecules such as rituximab or thrombopoietin receptor agonists (romiplostim and eltrombopag) have changed the management of immune thrombocytopenia. Therefore, old drugs which are less expensive and with a well-known benefit/risk ratio are being underused. We aim to define the place of dapsone, danazol, hydroxychloroquine and vinca-alkaloids at the era of targeted therapy in immune thrombocytopenia. With a response rate around 30% to 50%, dapsone is an interesting second-line therapy to be used just after corticosteroids. Patients with positive antinuclear antibodies can benefit from hydroxychloroquine with a 50% response rate. Because of its side effects, mostly virilization, danazol will be preferentially used in the elderly. Vinca-alkaloids could be temporarily used in patients that do not respond to intravenous immunoglobulins or to limit their use to avoid shortage periods.

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“…Many approaches exist, and because all have some efficacy, treatments tend to be physician- or center specific. Choices for severe and refractory disease include combination strategies [2], rituximab [3,4], splenectomy [5,6], vincristine [2,7], azathioprine/6MP [8-13], mycophenylate mofetil [14,15], danazol [16,17], and in severe cases, cyclophosphamide [18]. Few comparative studies exist to determine a “best next-line” therapy for these patients [19].…”

Section: Introductionmentioning

confidence: 99%

Response to mercaptopurine for refractory autoimmune cytopenias in children

Sobota

Neufeld

Lapsia

et al. 2008

Pediatric Blood & Cancer

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BackgroundSeveral treatment strategies are available for children with severe immune thrombocytopenic purpura (ITP) and other immune cytopenias refractory to initial therapies. 6‐Mercaptopurine (6MP) is one option, however it has not been well studied in children, especially as a single agent, and no pediatric case series have been reported since 1970.Patients and MethodsWe reviewed the experience at our institution over 8 years, using 6MP as a steroid sparing treatment for children with ITP, auto‐immune hemolytic anemia (AIHA) or Evans syndrome. A total of 29 pediatric patients were treated with 6MP from 2000 to 2007.ResultsResponse was defined as a rise in hemoglobin by at least 1.5 g/dl and to a level of 10 g/dl or greater in patients treated for anemia, or a platelet count ≥50 × 109/L in patients treated for thrombocytopenia. We found an overall response rate of 83% among all patients. Fourteen percent of patients stopped drug because of side effects.ConclusionsThese results suggest that 6MP can be an effective single‐agent treatment for refractory immune cytopenias in children. Prospective studies are warranted to determine long‐term efficacy and toxicity and to more clearly define patient populations most likely to respond. Pediatr Blood Cancer 2009;52:80–84. © 2008 Wiley‐Liss, Inc.

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The use of vinca alkaloids in adult patients with refractory chronic idiopathic thrombocytopenia

Cited by 25 publications

References 12 publications

Resolution of Hypersplenism and Pancytopenia in Common Variable Immunodeficiency Patient After Partial Splenic Artery Embolization: A Case Report and Review of Literature

Resolution of Hypersplenism and Pancytopenia in Common Variable Immunodeficiency Patient After Partial Splenic Artery Embolization: A Case Report and Review of Literature

Is there still a place for “old therapies” in the management of immune thrombocytopenia?

Response to mercaptopurine for refractory autoimmune cytopenias in children

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