Document Detail


Prediction of clinical outcome in patients with idiopathic thrombocytopenic purpura by evaluating bone marrow clot CD20+ B lymphocytes and morphological changes of megakaryocytes.
MedLine Citation:
PMID:  18434688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pathology of B-lymphocytes in the bone marrow of patients with idiopathic thrombocytopenic purpura (ITP) has not been well described, even though B-lymphocytes may be involved in the etiology of ITP. We retrospectively reviewed the medical records of 73 ITP patients between January 1997 and June 2005 with platelet counts of < 50 x 10(9)/L. Bone marrow clots were available for pathological review in 56 patients who were classified into 3 groups based on the results of the bone marrow clot examination : Group A (21 patients) had increased CD20+ lymphocytes (> or =1% of nucleated cells) and megakaryocytes with morphologic changes ; Group B (21 patients) had morphologic changes but no increase in CD20+ lymphocytes ; and Group C (14 patients) had neither morphologic changes nor increased CD20+ lymphocytes. Multivariate analysis showed that, compared to Group A, Group B had a significant prognostic factor (p = 0.04 ; odds ratio, 6.65 ; 95% confidence interval, 1.09 to 40.54) for achieving complete response, while Group C had a significant prognostic factor for any treatment response (p = 0.04 ; odds ratio, 14.26 ; 95% confidence interval, 1.08 to 188.02). Thus, ITP patients can be classified with different clinical outcomes based on immunohistopathological examination of bone marrow clots.
Authors:
Fumiko Yamamoto; Hiroto Narimatsu; Masafumi Ito; Satoshi Yamashita; Shingo Kurahashi; Takumi Sugimoto; Tatsuya Adachi; Isamu Sugiura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical and experimental hematopathology : JCEH     Volume:  48     ISSN:  1346-4280     ISO Abbreviation:  J Clin Exp Hematop     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-24     Completed Date:  2008-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101141257     Medline TA:  J Clin Exp Hematop     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  11-5     Citation Subset:  IM    
Affiliation:
Department of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antigens, CD20 / metabolism
B-Lymphocyte Subsets / pathology*
B-Lymphocytes / pathology*
Bone Marrow Cells / pathology*
Female
Helicobacter Infections / epidemiology
Helicobacter pylori
Humans
Immunohistochemistry
Male
Megakaryocytes / pathology*
Middle Aged
Prognosis
Purpura, Thrombocytopenic, Idiopathic / classification*,  microbiology,  pathology*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antigens, CD20

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