[Combination chemotherapy (CVP) in a patient with refractory idiopathic thrombocytopenic purpura (ITP)].

A 54-year-old woman, who had been given a diagnosis of idiopathic thrombocytopenic purpura (ITP) refractory to steroid therapy, was admitted to our hospital because of severe bleeding tendency. Splenectomy, high dose vitamin-C and interferon-alpha were not effective, although high-dose gamma-globulin had some effect. Since high-dose glucocorticoid was effective temporarily, we decided to perform chemotherapy. Seven courses of CVP chemotherapies (CVP; CPM 500 mg, VCR 2 mg, PSL 50 mg) prevented severe bleeding and did not have serious toxicity. Chemotherapy can be indicated for refractory ITP reactive to immunosuppressive therapy such as high-dose glucocorticoid.