Who are the Appropriate Candidates for Anti-D Treatment?
All subgroups of patients with ITP were represented in this series. Overall, IV anti-D treatment provided a hemostatic platelet increase for almost three quarters of the patients without prior splenectomy (Table 1). Moreover, approximately 50% of the treated patients had a platelet increase greater than 50 × 103/μL. The effect of anti-D lasted for more than 3 weeks in 50% of the responding patients and development of tachyphylaxis was infrequent. Children had substantially greater platelet increases than adults. We observed an abrupt change in the level of platelet increase at approximately 20 years, rather than a more gradual decrease with advancing age (Fig 1). No such dramatic difference in the platelet responses has been delineated between children and adults with other treatment modalities, although IVIG41 and splenectomy42 have been suggested to be more efficacious in children. The greater efficacy of anti-D in children as well as the tendency of ITP of childhood to remit spontan
