Programmed versus non-programmed freezing of umbilical cord blood.

sorption, danazol was replaced by azathioprine and a third course of vincristine was given. Six days later, the platelet count began to rise. Pharmacologic therapy was tapered down until withdrawal and the patient is in complete remission so far. Snyder et al. reported in 1992 a durable response in 36% of refractory ITP patients treated with Prosorba columns. The clinical response was associated with a significant decrease in specific serum platelet autoantibodies, PAIgG and circulating immune-complexes (CIC).2In these only two cases we have treated, we observed the immediate disappearance of anti-platelet GPIIb-IIIa and anti HLA class I antibodies from serum while the clinical response was timedelayed. However, the significance of removing circulating platelet autoantibodies in chronic ITP is questionable, since fewer than 50% of ITP patients have detectable antibodies in the serum and many of them are non-pathogenic. The immunomodulatory effect of the immunoadsorption is a better explanation of the late response observed in our patients. However, further studies are required to explain and validate the use of immunoadsorption treatment in refractory ITP.