Long-term danazol therapy in autoimmune thrombocytopenia: unmaintained remission and age-dependent response in women

Article Abstract:

A six-year study of 96 patients who received the medication danazol for thrombocytopenia is discussed. Thrombocytopenia results in a reduction of circulating blood platelets, which are important for blood clotting. Macrophage cells produced by the spleen function as a part of the immune system by destroying foreign bodies; in this autoimmune disease, platelets are mistaken for foreign substances and are attacked by the macrophages. When this condition occurs in the idiopathic (of unknown cause) form, it usually persists and the effectiveness of therapy is evaluated by the achievement of lasting results. The primary treatments for thrombocytopenia have been splenectomy (removal of the spleen) and glucocorticoids (steroid drugs). No therapeutic agent has been found that has long-lasting effects. The long-term value of danazol, an anabolic steroid, was evaluated and any side effects were also noted. The study group was composed of 60 women and 36 men. A good overall therapeutic success rate was achieved in the group, with 61.4 percent of the patients responding to the drug. Factors that influenced the effectiveness of danazol treatment were age, sex, and whether the spleen had been removed. In general, older women responded better to therapy with danazol than younger women did. It was suggested that this may be due to higher estrogen levels in the younger women; danazol may be less effective in this hormonal environment. No variations in response were noted in conjunction with age in the men. In general, patients without a spleen responded better to treatment. Remissions were induced when danazol was given for more than one year, and these remissions lasted for years after the drug was discontinued. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Physiological aspects, Danazol

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Partial remission of carcinoid tumor in response to cyproheptadine

Article Abstract:

Carcinoid tumor, a type of cancerous tumor, can create a side effect known as the carcinoid syndrome. This is the secretion of excess quantities of vasoactive substances such as serotonin which cause episodic flushing and diarrhea. Relief of these and other symptoms is sought by reducing tumor size using surgical methods or chemotherapy. A case report is described of an 80-year old woman who was treated with cyproheptadine for carcinoid syndrome. The patient's initial symptoms included episodic flushing, diarrhea, and weight loss. After hospitalization, enlargement of the liver was also observed. When test results revealed a metastatic carcinoid tumor in the liver, cyproheptadine was administered four times a day. Within a few weeks the patient's symptoms were relieved and a reduction of hepatic (liver) metastases was observed. Cyproheptadine is known to be a serotonin inhibitor; serotonin is a vasoactive substance. The observed reaction of this patient to the drug suggests that it is also has antineoplastic (cancer suppressant) properties. The investigators recommended that cyproheptadine be used in patients with phase II carcinoid tumors on the basis of this case and the low incidence of negative side effects of the drug. Further research is also recommended to clarify the mechanism that resulted in this antitumor effect and to explore the possible clinical uses for this drug. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Liver cancer, Carcinoid, Carcinoid tumor, Cyproheptadine

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Rituximab treatment of low platelet counts in a patient with chronic graft-versus-host disease

Article Abstract:

Doctors successfully used a drug called rituximab to treat a woman who developed abnormally low levels of blood platelets, a condition called thrombocytopenia. Her platelet count increased when she began taking the drug and returned to a normal level.

Complications and side effects, Graft versus host reaction, Graft vs. host disease

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