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Long-term outcomes in adults with chronic ITP after splenectomy failure
| Content Provider | Scilit |
|---|---|
| Author | McMillan, Robert Durette, Carol |
| Copyright Year | 2004 |
| Description | Adult chronic immune thrombocytopenic purpura (ITP) is an autoimmune disorder manifested by thrombocytopenia from the effects of antiplatelet autoantibodies and T lymphocyte–mediated platelet cytotoxicity. Multiple studies show that corticosteroid treatment and splenectomy, alone or together, increase platelet counts to safe levels in 60% to 70% of patients. However, there is little information on the outcomes of ITP patients refractory to splenectomy. We studied 114 patients with ITP for whom splenectomy failed and who required additional therapy; long-term follow-up was available on 105 (92%) patients. Seventy-five (71.4%) patients attained stable partial (platelet count greater than 30 × 109/L) or complete (normal platelet count) remission; 51 patients remained in remission after therapy was discontinued, whereas 24 patients required continued treatment. Median time to remission after splenectomy failure was 46 months (range, 1-437 months). Median remission durations were 60 months (range, 10-212 months) for patients off therapy and 48 months (range, 2-167 months) for patients on therapy. Thirty (29.6%) patients remained unresponsive to treatment. Thirty-two patients died, 17 (15.7%) of ITP (bleeding, 11 patients; therapy complications, 6 patients) and 15 (13.9%) of unrelated causes. We conclude that most patients with refractory ITP attain stable remission, though on average this occurs slowly. However, a subpopulation with severe, resistant disease experiences significant morbidity and mortality. |
| Related Links | http://bloodjournal.hematologylibrary.org/content/104/4/956.full.pdf |
| Ending Page | 960 |
| Page Count | 5 |
| Starting Page | 956 |
| DOI | 10.1182/blood-2003-11-3908 |
| Journal | Blood |
| Issue Number | 4 |
| Volume Number | 104 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 2004-08-15 |
| Access Restriction | Open |
| Subject Keyword | Hematology Autoantibodies Therapy Platelet Count Itp Lymphocyte Splenectomy Thrombocytopenia Autoimmune Refractory Journal: Blood (Vol- 78, Issue- 4) |
| Content Type | Text |
| Resource Type | Article |
