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Vincristine‐loaded platelet infusion for treatment of refractory autoimmune hemolytic anemia and chronic immune thrombocytopenia: Rethinking old cures
Author(s) -
Shvidel Lev,
Sigler Erica,
Shtalrid Mordechai,
Berrebi Alain
Publication year - 2006
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20632
Subject(s) - medicine , vincristine , splenectomy , autoimmune hemolytic anemia , refractory (planetary science) , platelet , gastroenterology , hemolytic anemia , anemia , evans syndrome , surgery , cyclophosphamide , chemotherapy , spleen , physics , astrobiology
We report our experience with vincristine‐loaded platelet infusion in patients with refractory immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA), and Evans syndrome. Ten patients with symptomatic thrombocytopenia and/ or hemolytic anemia who failed to respond to two to six different treatment modalities, including corticosteroids and splenectomy, were treated with infusion of vincristine‐loaded platelets. Platelets were harvested by plateletpheresis from a healthy ABO compatible blood donor and incubated with 5 mg vincristine. Excess of vincristine was removed, and platelets were resuspended in 50 ml plasma and infused over 30 min. All 10 patients responded, and 6 of them achieved complete remission. The response was prompt, occurring 3–8 days after vincristine‐loaded platelet infusion. Two patients with AIHA are still in remission 9 and 8 years posttreatment with no maintenance treatment. Three ITP patients achieved persisted partial response for 6 years, 5 years, and 11 months; in the remaining 5 patients the response lasted for 2–5 months. No side effects were seen. Our results suggest that this inexpensive and well‐tolerated treatment modality may be a useful approach in patients with ITP and AIHA refractory to primary therapy. Am. J. Hematol. 81:423–425, 2006. © 2006 Wiley‐Liss, Inc.