Research Article
Year 2023,
Volume: 9 Issue: 6 - November 2023, 1343 - 1349, 04.11.2023
Abstract
References
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- 2. Michel M. Immune thrombocytopenia nomenclature, consensus reports, and guidelines: what are the consequences for daily practice and clinical research? Semin Hematol 2013;50 Suppl 1:S50-4.
- 3. Semple JW, Rebetz J, Maouia A, Kapur R. An update on the pathophysiology of immune thrombocytopenia. Curr Opin Hematol 2020;27:423-9.
- 4. Nugent D, McMillan R, Nichol JL, Slichter SJ. Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production. Br J Haematol 2009;146:585-96.
- 5. Althaus K, Faul C, Bakchoul T. New developments in the pathophysiology and management of primary immune thrombocytopenia. Hamostaseologie 2021;41:275-82.
- 6. Audia S, Mahévas M, Samson M, Godeau B, Bonnotte B. Pathogenesis of immune thrombocytopenia. Autoimmun Rev 2017;16:620-32.
- 7. Sandal R, Mishra K, Jandial A, Sahu KK, Siddiqui AD. Update on diagnosis and treatment of immune thrombocytopenia. Expert Rev Clin Pharmacol 2021;14:553-68.
- 8. Lozano ML. New developments in the diagnosis of primary immune thrombocytopenia. Blood Coagul Fibrinolysis 2022; 33(Suppl 1):S5-S7.
- 9. Kochhar M, Neunert C. Immune thrombocytopenia: a review of upfront treatment strategies. Blood Rev 2021;49:100822.
- 10. Provan D, Arnold DM, Bussel JB, Chong BH, Cooper N, Gernsheimer T, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv 2019;3:3780-817.
- 11. Chang H, Tang TC, Hung YS, Li PL, Kuo MC, Wu JH, et al. Immune thrombocytopenia: effectiveness of frontline steroids and comparison of azathioprine, splenectomy, and rituximab as second-line treatment. Eur J Haematol 2018;101:549-55.
- 12. Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv 2019;3:3829-3866.
- 13. Xiao Y, Li TF. [Analysis of high-dose dexamethasone in different cycles on efficacy and safety of newly diagnosed ITP]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2018;34:436-40. [Article in Chinese]
- 14. Wang L, Xu L, Hao H, Jansen AJG, Liu G, Li H, et al. First line treatment of adult patients with primary immune thrombocytopenia: a real-world study. Platelets 2020;31:55-61.
- 15. Bizzoni L, Mazzucconi MG, Gentile M, Santoro C, Bernasconi S, Chiarotti F, et al. Idiopathic thrombocytopenic purpura (ITP) in the elderly: clinical course in 178 patients. Eur J Haematol 2006;76:210-6.
- 16. Daou S, Federici L, Zimmer J, Maloisel F, Serraj K, Andrès E. Idiopathic thrombocytopenic purpura in elderly patients: a study of 47 cases from a single reference center. Eur J Intern Med 2008;19:447-51.
- 17. Pamuk G, Pamuk Ö, Başlar Z, Öngören Ş, Soysal T, Ferhanoğlu B, et al. Overview of 321 patients with idiopathic thrombocytopenic purpura. Ann Hematol 2002;81:436-40.
- 18. Stasi R, Stipa E, Masi M, Cecconi M, Scimò MT, Oliva F, et al. Long-term observation of 208 adults with chronic idiopathic thrombocytopenic purpura. Am J Med 1995;98:436-42.
- 19. Leung A, Chim C, Kwong Y, Lie A, Au W, Liang R. Clinicopathologic and prognostic features of chronic idiopathic thrombocytopenic purpura in adult Chinese patients: an analysis of 220 cases. Ann Hematol 2001;80:384-6.
Year 2023,
Volume: 9 Issue: 6 - November 2023, 1343 - 1349, 04.11.2023
Abstract
Objectives: We aimed to reveal predictors of response and response duration to steroid therapy in first line of treatment in immune thrombocytopenia (ITP).
Methods: Fifty patients, who were diagnosed with ITP in hematology department of Suleyman Demirel University Hospital between 2005-2019, who had sufficient clinical and laboratory data, followed up for at least one year and received corticosteroid treatment in first line, were evaluated retrospectively for treatment response time, remission, prognosis on their first line treatment. The patients who maintained remission for more than 12 months was defined as group 1 and those who did not achieve remission or relapsed in less than 12 months were defined as group 2.
Results: Twenty-two (44%) patients responded in first 3 days of the treatment, 16 (32%) patients in 4 to 7 days and 4 (8%) patients responded in more than 7 days. Eighty-four percent (n = 42) of these patients had complete response to corticosteroid treatment. When the remission maintenances were examined, it was observed that 22 (44%) patients were in remission for more than 12 months, 20 (40%) patients were in remission with treatment but relapsed before 12 months and 8 (16%) patients did not respond to corticosteroid treatment. When the response time to treatment in patients with or without remission was compared, remission was significantly lower in those who responded late to treatment (p = 0.01). When the response rates to corticosteroid treatment of patients in group 1 and 2 were evaluated, it was found that the response time to treatment was not related to the maintenance of remission (p = 0.267).
Conclusions: Faster response time to treatment produced higher remission rates but, we could not find any relationship between response time to treatment and duration of remission.
References
- 1. Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 2009;113:2386-93.
- 2. Michel M. Immune thrombocytopenia nomenclature, consensus reports, and guidelines: what are the consequences for daily practice and clinical research? Semin Hematol 2013;50 Suppl 1:S50-4.
- 3. Semple JW, Rebetz J, Maouia A, Kapur R. An update on the pathophysiology of immune thrombocytopenia. Curr Opin Hematol 2020;27:423-9.
- 4. Nugent D, McMillan R, Nichol JL, Slichter SJ. Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production. Br J Haematol 2009;146:585-96.
- 5. Althaus K, Faul C, Bakchoul T. New developments in the pathophysiology and management of primary immune thrombocytopenia. Hamostaseologie 2021;41:275-82.
- 6. Audia S, Mahévas M, Samson M, Godeau B, Bonnotte B. Pathogenesis of immune thrombocytopenia. Autoimmun Rev 2017;16:620-32.
- 7. Sandal R, Mishra K, Jandial A, Sahu KK, Siddiqui AD. Update on diagnosis and treatment of immune thrombocytopenia. Expert Rev Clin Pharmacol 2021;14:553-68.
- 8. Lozano ML. New developments in the diagnosis of primary immune thrombocytopenia. Blood Coagul Fibrinolysis 2022; 33(Suppl 1):S5-S7.
- 9. Kochhar M, Neunert C. Immune thrombocytopenia: a review of upfront treatment strategies. Blood Rev 2021;49:100822.
- 10. Provan D, Arnold DM, Bussel JB, Chong BH, Cooper N, Gernsheimer T, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv 2019;3:3780-817.
- 11. Chang H, Tang TC, Hung YS, Li PL, Kuo MC, Wu JH, et al. Immune thrombocytopenia: effectiveness of frontline steroids and comparison of azathioprine, splenectomy, and rituximab as second-line treatment. Eur J Haematol 2018;101:549-55.
- 12. Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv 2019;3:3829-3866.
- 13. Xiao Y, Li TF. [Analysis of high-dose dexamethasone in different cycles on efficacy and safety of newly diagnosed ITP]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2018;34:436-40. [Article in Chinese]
- 14. Wang L, Xu L, Hao H, Jansen AJG, Liu G, Li H, et al. First line treatment of adult patients with primary immune thrombocytopenia: a real-world study. Platelets 2020;31:55-61.
- 15. Bizzoni L, Mazzucconi MG, Gentile M, Santoro C, Bernasconi S, Chiarotti F, et al. Idiopathic thrombocytopenic purpura (ITP) in the elderly: clinical course in 178 patients. Eur J Haematol 2006;76:210-6.
- 16. Daou S, Federici L, Zimmer J, Maloisel F, Serraj K, Andrès E. Idiopathic thrombocytopenic purpura in elderly patients: a study of 47 cases from a single reference center. Eur J Intern Med 2008;19:447-51.
- 17. Pamuk G, Pamuk Ö, Başlar Z, Öngören Ş, Soysal T, Ferhanoğlu B, et al. Overview of 321 patients with idiopathic thrombocytopenic purpura. Ann Hematol 2002;81:436-40.
- 18. Stasi R, Stipa E, Masi M, Cecconi M, Scimò MT, Oliva F, et al. Long-term observation of 208 adults with chronic idiopathic thrombocytopenic purpura. Am J Med 1995;98:436-42.
- 19. Leung A, Chim C, Kwong Y, Lie A, Au W, Liang R. Clinicopathologic and prognostic features of chronic idiopathic thrombocytopenic purpura in adult Chinese patients: an analysis of 220 cases. Ann Hematol 2001;80:384-6.
There are 19 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Haematology |
| Journal Section | Original Articles |
| Authors | |
| Early Pub Date | May 29, 2023 |
| Publication Date | November 4, 2023 |
| Submission Date | September 5, 2022 |
| Acceptance Date | December 30, 2022 |
| Published in Issue | Year 2023 Volume: 9 Issue: 6 - November 2023 |
e-ISSN: 2149-3189
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