Related Experiment Videos
[Treatment of immune thrombocytopenia: a retrospective study of 40 patients]
1Service de médecine interne et immunologie clinique, centre de compétence des cytopénies auto-immunes de Bourgogne Franche-Comté, hôpital du Bocage, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21079 Dijon cedex, France. sylvain.audia@chu-dijon.fr
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.
