High‐dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan. Issue 3 (13th November 2016)

• Record Type: Journal Article
• Authors: Yamazaki, Taro; Shibuya, Atsushi; Ishii, Saori; Miura, Nobuyuki; Ohtake, Akira; Sasaki, Nozomu; Araki, Ryuichiro; Ota, Yatio; Fujiwara, Mitsuhiro; Miyajima, Yuji; Uetake, Kimiaki; Hamahata, Keigo; Kato, Koji; Kawakami, Kiyoshi; Toyoda, Hidemi; Moriguchi, Naohiko; Okada, Masahiko; Nishi, Masanori; Ogata, Yoshiyasu; Takimoto, Tomohito; Ohga, Shouichi; Ohta, Shigeru; Amemiya, Shin
• Is Part Of: Pediatrics international. Volume 59:Issue 3(2017)
• Page Start: 303
• Page End: 308
• Publication Date: 2016-11-13
• Subjects: Cepharanthin -- child -- corticosteroid -- idiopathic thrombocytopenic purpura -- platelet count; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/ped.13151
• Languages: English
• ISSNs: 1328-8067

Abstract

Abstract: Background: A nationwide, multicenter and observational study was retrospectively conducted to evaluate the clinical utility of Cepharanthin (CEP) for pediatric patients with chronic immune thrombocytopenia (ITP). Methods: Clinical and laboratory data for 46 Japanese patients aged <16 years who were diagnosed as having chronic ITP in 14 hospitals during 2001–2011, and were treated with CEP for >12 months, were analyzed. Results: Median daily CEP dose was 1 mg/kg (range, 0.12–2 mg/kg). Median platelet count prior to CEP was 20.5 × 10 9 /L (IQR, 8.3–53.0 × 10 9 /L), and then significantly increased to 58.5 × 10 9 /L (IQR, 22.8–115.0 × 10 9 /L) and 69.0 × 10 9 /L (IQR, 23.0–134.0 × 10 9 /L) at 12 and 24 months of treatment, respectively. No life‐threatening bleeds or moderate–severe adverse events were reported. Of 38 patients who received both corticosteroids (CS) and CEP, 17 patients (45%) were weaned from CS, and 15 patients (39%) attained the reduced dose of CS. The duration from the start of CEP to the stopping of CS was a median of 413 days (range, 49–1734 days) in patients who were weaned from CS. Conclusions: CEP alone or combined with CS was useful for the management of pediatric chronic ITPs.