Treatment
Your doctor may decide whether or not treatment is necessary, depending upon your symptoms, platelet counts, and other laboratory test results. Patients with chronic ITP may receive different therapies over the course of treatment. No single therapy is right for every patient in all situations. 

Children

Initial treatment of children with acute ITP remains a topic of debate among physicians because often the disease resolves without any treatment. Treatment may be necessary to prevent restrictions of physical activity and prevention of excessive bleeding.1 

Adults

Approximately half of adults presenting to their physicians with symptoms of ITP have platelet counts below 10,000/mm3, putting them at risk for excessive bleeding. Therefore, adults generally require treatment at the time of diagnosis.1

  1. Cines D.B., Blanchette V.S. Immune Thrombocytopenic Purpura. New England Journal of Medicine. 2002; 346(13): 995-1008.  

Anti-D Immunoglobulin

WinRho® SDF is the only Anti-D Immunoglobulin approved for use in ITP in Canada. It is derived from human plasma (the liquid portion of blood) and is specially prepared to have high levels of a specific antibody, Anti-D. Currently it is thought that this antibody prevents the destruction of platelets in the spleen. Anti-D immunoglobulin (WinRho® SDF) is given by a 3-5 minute infusion into a vein. 

Please see Important Safety Section of this website for more information.

Anti-D may help raise the platelet level for 1-3 months after each infusion1,3. Periodic infusions of Anti-D may allow patients to achieve stable platelet counts.2 

Side Effects and What to do About Them:   

GENERAL

Most WinRho® SDF patients do not experience any drug related adverse effects. Among the few who do, the most commonly reported effects include headache, chills and fever. Rare side effects such as vomiting, nausea, low blood pressure, an increase in your heart beat, joint pain, anemia (decrease in red blood cells), intravascular hemolysis (destruction of red blood cells), back pain, shaking chills, hemoglobinuria (brownish discolouration of urine), and acute renal insufficiency (kidney failure) may also occur.

WinRho® SDF is made from human plasma, which may contain the causative agents of viral disease. The risk of getting a disease from this product has been reduced by screening plasma donors, testing for the presence of certain viruses and by utilizing manufacturing steps that inactivate and remove certain viruses. However, the potential to transmit infectious agents cannot be totally eliminated.

Please see the Important Safety Information section of this website for more information.

  1. Data on file. Cangene Corporation.
  2. Sandler S.G. and Tutuncuoglu S.O. Immune Thrombocytopenic Purpura -- current management practices. Expert Opin Pharmacother. 2004; 5(12): 2515-2527.
  3. WinRho® SDF. [Rho(D) Immune Globulin (Human) for Injection] Canadian Product Monograph, Cangene Corporation, Winnipeg, Canada, November 23, 2007.  

Intravenous Immunoglobulin (IVIG)

IVIG is derived from human plasma and contains a wide range of antibodies normally found in healthy individuals. It is thought to work by blocking the mechanism that causes platelets to be destroyed in the spleen.

IVIG is given intravenously (through the vein). Each treatment may require several hours and be repeated every 1-5 days. Treatment may raise platelet levels for three to four weeks. Some patients may experience such side effects as:

  • Headaches
  • Fever
  • Chills

Other possible side effects may include kidney problems, lung problems, heart attacks, or strokes.1,2 Because IVIG is made from human plasma, special processes are used in preparation of IGIV to safeguard against known viruses that may be found in human blood. However, the potential to transmit infectious agents cannot be totally eliminated.

  1. Sandler S.G. and Tutuncuoglu S.O. Immune Thrombocytopenic Purpura -- current management practices. Expert Opin Pharmacother. 2004; 5(12): 2515-2527.
  2. Grabenstein J.D. ImmunoFacts: Vaccines and Immunologic Drugs. St. Louis, MO: Wolters Kluwer Health Inc; 2006.  

Steroids (Corticosteroids)

Steroid therapy is a well-established, effective treatment for ITP. Steroids are thought to work by slowing the destruction of platelets in the spleen.

Steroids are normally given for only a short period of time because of the potential for serious side effects. These may include:1

  • High blood pressure
  • Diabetes
  • Cataracts
  • Difficulty sleeping
  • Facial swelling
  • Stomach ulcers
  • Abnormal hair growth
  • Mood changes/hyperactivity in children
  1. Sandler S.G. and Tutuncuoglu S.O. Immune Thrombocytopenic Purpura -- current management practices. Expert Opin Pharmacother. 2004; 5(12): 2515-2527.  

Splenectomy

Splenectomy is the surgical removal of the spleen. Approximately 2/3 or 67% of all patients who have a splenectomy have a good response. Removing the spleen may make the patient permanently susceptible to infections.1

  1. Cines D.B., Blanchette V.S. Immune Thrombocytopenic Purpura. New England Journal of Medicine. 2002; 346(13): 995-1008.