THE USE OF INTERFERON ALPHA IN THERAPY OF CHRONIC IMMUNE THROMBOCYTOPENIC PURPURA IN CHILDREN

H. Hrstkova, M. Bajer, J. Michálek

The First Paediatric Internal and Oncological Clinic, Medical Fac. MU, Brno, Czech Republic

OBJECTIVE. Treatment of chronic immune thrombocytopenic purpura (ITP) is barely effective, but promising results of interferon alpha therapy were reported recently.

METHODS. In a prospective study, 28 children between 4 and 18 years of age with chronic ITP were treated by recombinant human interferon alpha 2a (rh INFa-2a) with a single dose of 3MU/m2 three times a week for 4-5 weeks (1 cycle).

RESULTS. Very good (platelets > 100 x 109/l in peripheral blood) and good (50-100 x 109/l) therapeutic responses at the end of rh INFa-2a therapy were reached in 12 (42.8%) and 10 (35.7%) out of 28 patients, respectively. After 6 months of follow-up 18 out of 26 (69.2%) evaluable patients sustained in very good or good therapeutic response. In 11 evaluable patients after 12 months of follow-up 8 (72.7%) were in very good or good therapeutic response. 11 out of 28 children had severe chronic ITP with platelets < 20 x 109/l and 6 (54.6%) of them showed good or very good response at the end of interferon alpha cycle and 5 (45.5%) sustained in very good or good response for 6 months. Repeated cycles or interferon alpha therapy were administered to 8 poor responders (platelets < 50 x 109/l) with very good or good response lasting for at least 6 months in 6 (75%) of them. Frequent side effect of interferon alpha is transient fever, less frequently flu-like syndrome may by present.

CONCLUSIONS. It is apparent that interferon alpha is an effective therapeutic approach to children with chronic ITP with minimum side effects, leading frequently to sustained remission of the disease.