Refractory Idiopathic Thrombocytopenic Purpura Treated with Azathioprine

Abstract

OUR results in the treatment of idiopathic thrombocytopenic purpura with splenectomy and corticosteroids have previously been reported. In our overall, long-term, evaluation of 271 patients with idiopathic thrombocytopenic purpura 7.7 per cent failed to respond to either method of therapy, and 4.4 per cent subsequently died from fatal bleeding.¹ Over the past six years there has been an increasing interest in the suppression of the immune response by antimetabolites.^{2 3 4 5 6 7 8 9 10} Schwartz and Dameshek¹¹ first reported their encouraging results in the treatment of autoimmune hemolytic anemia with 6-mercaptopurine or thioguanine.Azathioprine, 6-(1-methyl-4-nitro-5-imidazolyl)-thiopurine, B.W. 57–322, developed in recent years, is related to 6-mercaptopurine . . .