Document Detail


[Treatment outcome of immune thrombocytopenia].
MedLine Citation:
PMID:  23045311     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Treatment of immune thrombocytopenia is sometimes difficult and needs personal setting. According to evidence-based guidelines, corticosteroids are suggested for first-line treatment. In case of corticosteroid ineffectiveness, second-line therapeutic options (splenectomy, immunosuppressive drugs and, recently, thrombopoietin-mimetics) may result in beneficial therapeutic effect.
AIMS: The aim of the authors was to examine the clinicopathological data, disease course, treatment results, and the effectiveness of novel drugs in patients with immune thrombocytopenia.
PATIENTS AND METHODS: The authors retrospectively analysed the files of 79 immune thrombocytopenic patients (26 males and 53 females) diagnosed and treated at the hematologic in- and outpatient units of the Markusovszky Hospital, County Vas, Hungary between January 1, 2000 and December 31, 2011. Remission rates, disease-free and overall survivals in response to corticosteroids (first-line treatment), after splenectomy (in cases when corticosteroids proved to be ineffective) and following second-line treatment were analysed. Survival curves were constructed using statistical software programs.
RESULTS: Of the 79 patients during a median follow-up of 66 months (min. 3, max. 144 months), 28 patients receiving first-line corticosteroids achieved complete remission and remained in a prolonged disease-free condition (35.4%; median disease-free survival 75.5 months; min. 2, max. 140 months). Thirty-eight patients underwent splenectomy after ineffective treatment with corticosteroids or other immunosuppressive (48.0%; median disease-free survival 94.2 months; min. 6, max. 136 months). Surgical complications occurred in 2 cases, while postoperative and late infections were absent. Five patients died but death was not related to immune thrombocytemia. Second-line treatment was applied in 13 patients (16.4%) and among these patients relapse of immune thrombocytopenia after splenectomy was observed in 6 patients. Favourable effects of both conventional (immunosuppressive) and novel treatments (rituximab, thrombopoietin-mimetics) were also detected.
CONCLUSIONS: More than two-thirds of patients with immune thrombocytopenia responded to corticosteroids or to splenectomy and achieved prolonged disease-free remission. Novel drugs (rituximab, thrombopoietin-mimetics) applied only in few cases produced also favourable results in patients not responding to corticosteroids and splenectomy.
Authors:
János László Iványi; Eva Marton; Márk Plander
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Orvosi hetilap     Volume:  153     ISSN:  0030-6002     ISO Abbreviation:  Orv Hetil     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-09     Completed Date:  2012-12-20     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0376412     Medline TA:  Orv Hetil     Country:  Hungary    
Other Details:
Languages:  hun     Pagination:  1613-21     Citation Subset:  IM    
Vernacular Title:
Immun thrombocytopeniás betegek kezelésével szerzett tapasztalataink.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal, Murine-Derived / therapeutic use
Disease-Free Survival
Female
Follow-Up Studies
Hospitals, County / statistics & numerical data*
Humans
Hungary / epidemiology
Immunosuppressive Agents / therapeutic use*
Male
Middle Aged
Purpura, Thrombocytopenic, Idiopathic / drug therapy*,  immunology,  mortality,  surgery*
Recurrence
Retrospective Studies
Splenectomy*
Survival Analysis
Thrombopoietin / agonists
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal, Murine-Derived; 0/Immunosuppressive Agents; 0/rituximab; 9014-42-0/Thrombopoietin

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


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