In:
Acta Haematologica, S. Karger AG, Vol. 145, No. 5 ( 2022), p. 465-475
Abstract:
〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 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 ( 〈 i 〉 p 〈 /i 〉 = 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%, 〈 i 〉 p 〈 /i 〉 = 0.0220) than in nonresponders (60.0%) and poor responders (59.4%). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 First-line IVIG response is indicated as a useful predictive factor for response to splenectomy.
Type of Medium:
Online Resource
ISSN:
0001-5792
,
1421-9662
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
1481888-7
detail.hit.zdb_id:
80008-9
