Chemo and ITP

My realative has been in the hospital for 47 days from ITP (platelets in the 1,000 to 6,000 range). We have going through all the standard ITP treatments (Rituxan, Steriods, etc.). Nothing has worked. The doctors are now discussing Chemotherapy drugs.

Has anyone had experience with Chemo and ITP?

Have they tried N-PLate or Promacta? Those have a much better success rate than the two chemo's that are rarely used (Vincristine and Cytoxin). The chemo's don't work very well for ITP and can have permanent side effects.

I hope your relative has a doctor that is experienced with ITP. That can make a huge difference.

They have tried N-plate and Promacta for 40ish days. Her platlets continue to drop to basically zero. The doctors are in consultation with Dr Andrews and Dr. George. I believe Dr. Andrews is a contributure on this web site.

I worry they are treating the wrong thing and that possible she has MDS not ITP.

How old is she? Has she had a bone marrow biopsy? How are symptoms?

I'd be the last person to question these particular experts.
But... unless she has been on the maximum dose of NPlate or Promacta for at least a month, it shouldn't be declared a failure. And since she's only been in treatment slightly more than a month total, there wouldn't have been enough time to initiate a TPO agonist at the lowest dose and work up to the highest. They just don't typically work that fast.

My hemo doesn't prescribe the chemo drugs for ITP because of side effects too dangerous and intolerable for the low success rate.

71...signs are tons of bruising, internal GI bleeding (a little better last couple days), low hemo and platlets in low 1000's. Other vitals are normal. Spleen has been removed.

My experience with NPlate was that it took 6 weeks to get a response and that was at the 8mcg dosage level which finally took me to 33. I started off at 1mcg and this was gradually increased during the 6 weeks. After that the dosage level was adjusted to try and stabilise my count which it eventually did after another 5 months.