Successful treatment of idiopathic thrombocytopenic purpura-like syndrome in a cancer patient with low-dose interferon: case report and review of the literature

Am J Hematol. 2004 Aug;76(4):353-9. doi: 10.1002/ajh.20116.

Abstract

Idiopathic thrombocytopenic purpura (ITP)-like syndrome is a rare complication of carcinomas, and its treatment usually precedes cancer therapy in order to make further procedures safe. We describe the case of a 78-year-old man with a small-cell lung cancer of extended stage, associated with ITP-like syndrome, which proved resistant to treatment with corticosteroids and vincristine, short-responsive to IV immunoglobulin, but quickly and steadily responsive to low-dose interferon (ld IFN, 3 million IU, sc, twice weekly, for 8 weeks), until the patient's death, due to his primarily chemoresistant cancer. This case is, to our knowledge, the second reported ITP-like syndrome in a cancer patient who had been successfully treated with ld IFN. The excellent and cost-effective therapeutic index of ld IFN makes it an attractive alternative treatment in patients with this specific complication and calls for further investigation regarding its potential use as a first-line treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Autoimmune Diseases / drug therapy*
  • Autoimmune Diseases / etiology
  • Carcinoma, Small Cell / complications*
  • Carcinoma, Small Cell / immunology
  • Cyclosporine / therapeutic use
  • Drug Resistance
  • Drug Resistance, Neoplasm
  • Fatal Outcome
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Lung Neoplasms / complications*
  • Lung Neoplasms / immunology
  • Male
  • Platelet Count
  • Prednisolone / therapeutic use
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Purpura, Thrombocytopenic, Idiopathic / etiology
  • Recombinant Proteins
  • Remission Induction
  • Vincristine / therapeutic use

Substances

  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Vincristine
  • Cyclosporine
  • Prednisolone