[Treatment of immune thrombocytopenia: a retrospective study of 40 patients].

Abstract

PURPOSE:

Immune thrombocytopenia (ITP) is an auto-immune disease associating a peripheral platelet destruction without increased central production.

METHODS:

Forty patients with chronic ITP were retrospectively analyzed for clinical and biological presentation and response to treatment.

RESULTS:

Mean age at diagnosis was 54 years. ITP was revealed by hemorrhage in 65 % of the patients. Despite very low platelet count, no life threatening hemorrhage was observed. Platelet associated antibodies were found in 66 %, usually directed against GPIIb/IIIa. Corticosteroids were used as first line treatment, with response in 54 %, and relapse in 86 %. A response was observed in 42.1 % with dapsone, which was well tolerated, a relapse occurring in 37.5 % of the patients. Rituximab (RTX) allowed a response rate of 42.1 %, prolonged in 40 % of the patients. A response was achieved in 42.9 % cases after splenectomy, without any relapse. No factor was identified to predict the response to treatment.

CONCLUSION:

ITP is a rare disorder occurring most frequently in middle aged patients. Because of high relapse or no response rates, many treatments should be used. Dapsone offers a good efficacy without major side effects. RTX is well tolerated and allows a good response rate. The use of new agents like thrombopoietin receptor agonist or new therapeutics against B lymphocytes should be defined.

• Authors: S Audia, D Lakomy, J Guy, V Leguy-Seguin, S Berthier, S Aho, B Lorcerie, B Bonnotte
• Journal: La Revue de medecine interne (Rev Med Interne) Vol. 31 Issue 5 Pg. 337-44 (May 2010) ISSN: 1768-3122 [Electronic] France
• Vernacular Title: Traitement du purpura thrombopénique immunologique : étude rétrospective de 40 patients.
• PMID: 20409619 (Publication Type: English Abstract, Journal Article)
• Copyright: Copyright 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Chemical References

• Anti-Infective Agents
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Glucocorticoids
• Immunologic Factors
• Rituximab
• Dapsone

Topics

• Adult
• Aged
• Anti-Infective Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Murine-Derived
• Dapsone (therapeutic use)
• Drug Therapy, Combination
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Immunologic Factors (therapeutic use)
• Male
• Middle Aged
• Purpura, Thrombocytopenic, Idiopathic (diagnosis, drug therapy, surgery, therapy)
• Retrospective Studies
• Rituximab
• Splenectomy
• Treatment Outcome