Success rates for prednisone treatment?

My mother, age 52, was recently diagnosed with ITP around 6 days ago. Needless to say, both our lives have been thrown into turmoil with this recent development. Her initial platelet count was 8. After emergency platelet transfusion it went up to 20 and a hematologist prescribed a course of prednisone. From what I've gathered online, reading various reports, I've noticed a lot of stories about how ITP patients often suffer from a relapse after gradually stopping the steroid treatment. Reading so many posts about how the platelet count falls again after discontinuing prednisone gives me the impression (hopefully false) that a relapse is more of a foregone conclusion, rather than a possibility. I wanted to know from someone more experienced in the subject of ITP to tell me how high the chances of a relapse actually are, and how effective prednisone is in treating ITP. Thank you.

Hello lamasia. Based on what I've picked up, let me take a swing at that question. About 30% of all ITP patients will have a 'strong' response to Prednisone/steroids. Of that 30% perhaps as much as one third will have a strong enough response so that they will eventually gain remission through steroid treatment alone.

So in the case of your mother, if she is responding now (yes ?) the chances of a relapse are almost sure - because as you say relapse is common on weening off the drug. Up to four 'Dex pulses' can be a good treatment for those that respond to steroids.

Hope this helps...

Iamasia:

There are two types of ITP; acute and chronic. An acute case of ITP can occur after an illness, a new medication or supplement, a vaccine, etc. If a person is acute, Prednisone may work to get the counts up and they could stay there. I've seen it happen, so I wouldn't get too discouraged yet. Acute ITP can last for months, meaning that there could be a relapse or two before counts stay up indefinitely.

However, most adults do tend to be chronic. That is not to say that your mother will have ITP for the rest of her life. Remissions do occur, but it can take time to get there. There is no quick fix for ITP, not even splenectomy, although many doctors state that it is a cure. It's not, and counts often fall after splenectomy. I was diagnosed at the age of 37, and struggled with ups and downs for 8 years. I went into remission in 2004 and have been there since. I never expected it.

ITP can turn life upside down at first, but please know that it is generally a manageable disorder. Most people live a normal life with a few adjustments, mainly treatments. As long as a count over 30k is maintained, it is considered to be a safe count for daily living. Normal counts are not necessary. It's important to have a knowledgeable hematologist who will not aggressively over-treat. Treatments can be worse than the illness itself. Platelet transfusions are contraindicated for ITP unless bleeding is present, so if your mom's hemo uses that as a treatment, you might want to get another opinion.

How are your mom's counts responding to Prednisone?

I wouldn't exactly say she hasn't responded at all. The doctor started her off on a low dose of prednisone, around 40mg and 6 days later the count was still at 20. Now her dosage has been increased to 50mg. According to the doctor results can take a bit longer than 6 days to improve.

Platelet transfusion wasn't used as an means to an end. The doctor suggested it to bring up counts to a stable level before doing anything else. I really hope we don't need to go any further than prednisone treatment to gain remission. Thanks for your answers, Hal9000 and Sandi.

Well, people who are good Prednisone responders will see a big platelet increase within days. On 40 mg's, some people would be over 100k in three or four days. See how she does with the next count but if there is not a big change, Prednisone probably isn't the best treatment for her.