Document Detail


Splenectomy-sparing strategies for the treatment and long-term maintenance of chronic idiopathic (immune) thrombocytopenic purpura.
MedLine Citation:
PMID:  10676916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with idiopathic thrombocytopenic purpura (ITP) have vulnerability to additional bleeding, leaving them susceptible to severe hemorrhaging. Low platelet counts contribute to this rare, but significant outcome, but may not be the sole determinant. Although the only current treatment of ITP felt to be curative is surgical removal of the spleen, the long-term outcome for these patients is not well defined. Our group Investigated the use of Intravenous gamma-globulin in the treatment of children with chronic ITP as a means to defer splenectomy. A variation of this approach uses anti-D to block splenic macrophages with antibody-coated red blood cells. There may be a correlation between response to anti-D and response to splenectomy in adults with ITP. Because the long-term results of splenectomy are not well defined, additional clinical studies are warranted. Questions requiring further study Include whether repeated Infusions of anti-D could allow the postponement and ultimate avoidance of splenectomy and whether the role of anti-D may be for pregnant women who are not readily eligible for splenectomy. Such an analysis should include information on the long-term outcome of splenectomy as well as information on whether patients have a durable improvement. Such studies about the potential outcomes of splenectomy and of avoidance of splenectomy will help identify new treatment strategies that may help to eliminate the need for this procedure in patients with chronic ITP.
Authors:
J B Bussel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in hematology     Volume:  37     ISSN:  0037-1963     ISO Abbreviation:  Semin. Hematol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-25     Completed Date:  2000-02-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0404514     Medline TA:  Semin Hematol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-4     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Hematology and Oncology, New York Hospital-Cornell Medical Center, New York 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Isoantibodies / therapeutic use
Male
Pregnancy
Purpura, Thrombocytopenic, Idiopathic / drug therapy,  physiopathology,  surgery*
Splenectomy*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Isoantibodies; 0/RHO(D) antibody

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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