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Diagnosed With Idiopathic Thrombocytopenic Purpura. Did Platelet Count. Took Prednisone. Chances Of Having Leukaemia?

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Posted on Thu, 21 Nov 2013
Question: Hi. My daughter has been diagnosed with ITP. She was hospitalized when her platelet count was >10. She was given 80 mg prednisone for 2 days. No effect. Dexamethasone 40mg for 4 days, her platelet count started to go up. It's been a bit over a month and when she left the hospital, it was 35. With at-home Dexamethane treatment, she eventually got up to 149. Two days ago she was down to 38 and today it was 32. Doctors want to use Rituximab 4 treatments of 6 hours each. She is 22 years old and in college. I will get a second opinion at our local Hospital, UPenn. My mother died of non hodgkin's leukemia. Looking up Rituximab I found it is a drug that is also used for this disease. My questions are: What do you think of this course of treatment? Could this possibly turn into some sort of Leukemia? Ruled out: Hep a,b,c Aids Lupis anticoagulant. What can I do. My first son died at 19 y/o from a fall that caused bleeding in his brain. I will do anything to keep my daugher alive. I'm very anxious.
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Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer: ITP does not turn to cancer Detailed Answer: Hi Thanks for your query. ITP is a disorder where the body's immunity kills its own platelets. Hence the treatment is some form of immune suppression, whereby this immune response is dampened so that the platelet count improves. Steroids like dexamethasone are for the same reason. However, sometimes when the dose of steroids is reduced, the platelet count falls. At this time other medicines are used. Rituximab is an anti B cell antibody which can also act in ITP by acting against the B lymphoid cells and thereby dampening the immune response. It is also used in B cell lymphomas. but ITP has nothing to do with B cell lymphomas or leukemia. Overall I feel that she is on the right track. You can take a second opinion but I think she should do just fine with this. Hope I have answered your query. I will be available to answer further followup queries, if any.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Indranil Ghosh

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Practicing since :2004

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Diagnosed With Idiopathic Thrombocytopenic Purpura. Did Platelet Count. Took Prednisone. Chances Of Having Leukaemia?

Brief Answer: ITP does not turn to cancer Detailed Answer: Hi Thanks for your query. ITP is a disorder where the body's immunity kills its own platelets. Hence the treatment is some form of immune suppression, whereby this immune response is dampened so that the platelet count improves. Steroids like dexamethasone are for the same reason. However, sometimes when the dose of steroids is reduced, the platelet count falls. At this time other medicines are used. Rituximab is an anti B cell antibody which can also act in ITP by acting against the B lymphoid cells and thereby dampening the immune response. It is also used in B cell lymphomas. but ITP has nothing to do with B cell lymphomas or leukemia. Overall I feel that she is on the right track. You can take a second opinion but I think she should do just fine with this. Hope I have answered your query. I will be available to answer further followup queries, if any.