Twenty-five children diagnosed and treated as chronic ITP between 1986-1996 in the Department of Pediatric Hematology / Oncology and Our Children Leukemia Foundation at Istanbul University, Istanbul Medical School. Six patients (23%) had no response to conventional treatment including splenectomy characterized as refractory. Five patients (3 males,2 females) with a median age of 6.5(range 5-10 years) treated with cyclosporine A (CYA, 10-12 mg / kg / d, b.i.d). One patient didn't receive CSA because of renal failure. Median platelet count was 18x109/1 (range 10-28x109 /1) at the onset of CSA and all patients had bleeding symptoms.The median interval from diagnosis to treatment was 30 months (range 17-124 months). 4/5 patients had a good response to CSA at the first month of treatment with normal platelet count(median 150x109/1, range 140-186). Median duration of treatment was 2 years (range 9-24 months) with minimal side effects. One patient relapsed 1 and 5 months after cessation of CSA and he is treated again with CSA with a good response and he is now having CSA for 2 years.

In our experience, CSA therapy in refractory chronic ITP patients especially after splenectomy is a very successful treatment modality with minimal side effects.