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August 23, 1958


Author Affiliations

New England Center Hospital Boston 11, Mass.

JAMA. 1958;167(17):2117-2118. doi:10.1001/jama.1958.02990340077016

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To the Editor:—  In our recent article on the treatment of idiopathic thrombocytopenic purpura (ITP) with prednisone (J. A. M. A. 166:1805-1815 [April 12] 1958), we noted in an addendum that two additional patients with ITP treated with triamcinolone showed excellent hematologic responses. Further observations indicated that the latter product had hematological effects resembling closely those obtained with prednisone. Subsequent use of this product indicates that in the relatively high doses required in our patients, a rather high incidence of a variety of nonhematological reactions occurred. As a result, we are reappraising its usefulness when administered in the dosages required for the therapy of the various hematological disorders. Sixteen consecutive patients with hematological disease (ITP, autoimmune hemolytic anemia, and leukemia) were treated with triamcinolone in maximal dosages varying from 12 to 100 mg. daily. The latter dosage was used in only one patient (with severe autoimmune hemolytic anemia); in six

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