|
|
Blood, 15 August 2004, Vol. 104, No. 4, pp. 956-960.
Prepublished online as a Blood First Edition Paper on April 20, 2004; DOI 10.1182/blood-2003-11-3908.
 Previous Article | Table of Contents | Next Article 
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Long-term outcomes in adults with chronic ITP after splenectomy failure
Robert McMillan, and
Carol Durette
From the Scripps Research Institute and the General Clinical Research Center, Green Hospital, La Jolla, CA.
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 x 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.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
Related Article in Blood Online:
-
ITP: the bad actors
- Alan Lichtin
Blood 2004 104: 912.
[Full Text]
[PDF]
This article has been cited by other articles:
|
|
|
|
 
D. B. Cines, J. B. Bussel, H. A. Liebman, and E. T. Luning Prak
The ITP syndrome: pathogenic and clinical diversity
Blood,
June 25, 2009;
113(26):
6511 - 6521.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. B. Bussel, D. J. Kuter, V. Pullarkat, R. M. Lyons, M. Guo, and J. L. Nichol
Safety and efficacy of long-term treatment with romiplostim in thrombocytopenic patients with chronic ITP
Blood,
March 5, 2009;
113(10):
2161 - 2171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Burzynski
New options after first-line therapy for chronic immune thrombocytopenic purpura
Am. J. Health Syst. Pharm.,
January 15, 2009;
66(2_Supplement_2):
S11 - S21.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ruggeri, S. Fortuna, and F. Rodeghiero
Heterogeneity of terminology and clinical definitions in adult idiopathic thrombocytopenic purpura: a critical appraisal from a systematic review of the literature
Haematologica,
January 1, 2008;
93(1):
98 - 103.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Kumagai, T. Fujita, M. Ozaki, K. Sahashi, M. Ohkura, T. Ohtsu, Y. Arai, Y. Sonehara, and J. L. Nichol
Pharmacodynamics and Pharmacokinetics of AMG 531, a Thrombopoiesis-Stimulating Peptibody, in Healthy Japanese Subjects: A Randomized, Placebo-Controlled Study
J. Clin. Pharmacol.,
December 1, 2007;
47(12):
1489 - 1497.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Cines and J. B. Bussel
How I treat idiopathic thrombocytopenic purpura (ITP)
Blood,
October 1, 2005;
106(7):
2244 - 2251.
[Full Text]
[PDF]
|
|
|
|
|
