Chronic management of the immune-mediated blood disorders

摘要

The cornerstone of the management of both immune-mediated haemolytic anaemia (IMHA) and immune-mediated thrombocytopenia (IMT) is immunosuppressive therapy, particularly with glucocorticoids. Some of the major mechanisms of immunosuppressive therapy are to decrease antibody synthesis, decrease the binding affinity between antibodies and blood cells, and decrease destruction of antibody-coated cells by the mononuclear phagocytic system (MPS). However, because even if new antibody synthesis by plasma cells is arrested immediately, pre-existing immunoglobulins may survive in the circulation for weeks, reduction of antibody synthesis is usually not an important part of the initial treatment of IMHA or IMT.