"Refractory" Thrombocytopenic Purpura Treated Successfully With Cyclophosphamide

Immunosuppressive agents have been used with varying success in the treatment of thrombocytopenic purpura. Cyclophosphamide, a potent immunosuppressive agent with a good therapeutic index, has, to our knowledge, not been used in the treatment of this disorder. Our experience consists of the study of 11 patients previously treated with corticosteroids. The spleens of nine had been removed. Cyclophosphamide was administered in a daily dose of from 50 to 200 mg. Seven patients had an excellent response and have remained in complete hematologic remission for 10 to 40 months after discontinuation of all therapy. Four patients had a fair response, a definite improvement of platelet levels which have not reached or remained at normal levels. Our experience indicates that cyclophosphamide can be a safe and effective means of inducing remission in patients refractory to conventional therapy.