Splenectomy Outcomes in Relapsed or Refractory Immune Thrombocytopenia according to First-Line Intravenous Immunoglobulin Response.
Acta Haematol
; 145(5): 465-475, 2022.
Article
en En
| MEDLINE
| ID: mdl-35016175
ABSTRACT
OBJECTIVES:
Although splenectomy has long been second-line option for immune thrombocytopenia (ITP) patients, an indicator that reliably predicts the efficacy of splenectomy is still being explored. We investigated the treatment outcomes of splenectomy as a second-line therapy for relapsed/refractory ITP according to first-line intravenous immunoglobulin (IVIG) responses.METHODS:
Fifty-two adult patients treated with splenectomy as second-line therapy for ITP between 2009 and 2019 were included, and they were classified according to first-line IVIG responses (no response to IVIG nonresponders; only transient IVIG response shorter than 4 weeks poor responders; IVIG response for a longer period; stable responders). The efficacy of splenectomy was analyzed in the three subgroups.RESULTS:
Of the 52 patients, 10 were IVIG nonresponders, 34 were poor responders, and the remaining 8 were stable responders. Response to splenectomy was observed in 50.0% of IVIG nonresponders, 94.1% of poor responders, and 100% of stable responders (p = 0.0030). Among the 45 patients who responded to splenectomy, 51.1% relapsed subsequently, and a significantly lower relapse rate was noted in the stable IVIG responders (12.5%, p = 0.0220) than in nonresponders (60.0%) and poor responders (59.4%).CONCLUSIONS:
First-line IVIG response is indicated as a useful predictive factor for response to splenectomy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Trombocitopenia
/
Púrpura Trombocitopénica Idiopática
Tipo de estudio:
Prognostic_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Acta Haematol
Año:
2022
Tipo del documento:
Article