Combination Chemotherapy in Refractory Immune Thrombocytopenic Purpura

Chronic immune thrombocytopenic purpura is an autoimmune disorder in which autoantibodies against platelet membrane proteins, most commonly the glycoprotein IIb/IIIa and Ib/IX complexes, cause platelet destruction by the reticuloendothelial system 1 , 2 . Immune thrombocytopenia may also be associated with other disorders, such as collagen vascular disease, lymphoproliferative disorders, and other autoimmune syndromes. High-dose corticosteroids are the initial treatment of choice; their use, however, results in lasting remission in only 10 to 20 percent of patients 3 – 5 . Patients who do not respond to corticosteroids undergo splenectomy, which results in complete or partial remission requiring no further therapy in about 60 . . .