Comparison of the efficacy of a two-day and a five-day schedule for infusing intravenous gamma globulin in the treatment of immune thrombocytopenic purpura in adults.

The standard schedule for treating immune thrombocytopenia purpura in adults with intravenous immunoglobulin G infusion (IVIG), 400 mg/kg per day for five days, was compared with a shorter schedule using 1,000 mg/kg per day for two days. Both schedules were found to be effective in correcting thrombocytopenia. Eleven of the 17 patients treated with the five-day regimen and nine of 10 patients treated with the two-day regimen had significant responses. Patients with an initial platelet count of less than 20,000 platelets/mm3 or with an estimated in vivo platelet survival in excess of 90 hours were less likely to have a response than were other patients. There were no serious side effects in either group, but thrombophlebitis was observed in some patients receiving the five-day regimen when a single intravenous catheter was used for more than three days. Headaches and, less commonly, low-grade fever were noted in some patients receiving the two-day regimen when infusions were given at flow rates in excess of 0.04 ml/kg/minute. Since the two-day regimen requires shorter hospitalization and corrects thrombocytopenia slightly faster than the five-day course, it may be particularly useful in correcting thrombocytopenia in hospitalized patients requiring splenectomy or other surgery.

Duke Scholars

Author Joseph Odell Moore Medicine, Hematological Malignancies

Author Jon Paul Gockerman Medicine, Hematologic Malignancies and Cellular Therapy