Have splenectomy rate and main outcomes of ITP changed after the introduction of new treatments? A monocentric study in the outpatient setting during 35 years

American Journal of Hematology
Francesca PalandriNicola Vianelli

Abstract

In the last years, rituximab (RTX) and agonists of the thrombopoietin receptor (TPO-R) eltrombopag and romiplostim have provided new treatment options in persistent and chronic immune thrombocytopenia (ITP). Here, we analyzed the changes in therapeutic choices over time and their impact on clinical outcomes in a cohort of 557 ITP outpatients followed at the "L. and A. Seràgnoli" Institute of Hematology, Bologna, Italy, from 1980 to 2015. Overall 397 patients (71%) required front-line corticosteroids, mainly prednisone. Over the decades, splenectomy was delayed from second to third-line, but was steadily used in around 15-25% of patients refractory or relapsing after first-line treatment. Consensually, RTX and TPO-R agonists emerged as second and third-line therapy of choice, respectively. Splenectomy was associated with the best response rates and the lower incidences of relapse, while the relapse rate after RTX was comparable to that observed with corticosteroids and other immunosuppressive agents. The introduction of TPO-R agonists gave an alternative to the administration of immunosuppressive drugs and probably contributed to moderate the incidence of infectious complications that remained stable over the decades, despite an...Continue Reading

References

Aug 29, 2003·The New England Journal of Medicine·Yunfeng ChengGregory Cheng
Jan 22, 2005·Annual Review of Medicine·Douglas B Cines, Robert McMillan
Mar 30, 2005·American Journal of Hematology·Peter BraendstrupHans C Hasselbalch
Dec 22, 2005·American Journal of Hematology·Drew ProvanJames B Bussel
Nov 2, 2006·Blood·Maria Gabriella MazzucconiUNKNOWN Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA) Thrombocytopenia Working Party
Jan 4, 2007·Annals of Internal Medicine·Donald M ArnoldJohn G Kelton
Nov 21, 2007·Hematology·Sherrill J Slichter
Jan 25, 2008·Thrombosis and Haemostasis·Roberto StasiSergio Amadori
Nov 12, 2010·The New England Journal of Medicine·David J KuterDietmar P Berger
Feb 18, 2011·Blood·Cindy NeunertUNKNOWN American Society of Hematology
Jan 29, 2013·Daru : Journal of Faculty of Pharmacy, Tehran University of Medical Sciences·Mohammad Ali MashhadiEbrahim Miri-Moghaddam
May 25, 2013·International Journal of Hematology·Hirokazu Kashiwagi, Yoshiaki Tomiyama
Mar 21, 2015·Seminars in Thrombosis and Hemostasis·Adam CukerDouglas B Cines

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Citations

Oct 28, 2016·International Journal of Hematology·Moonhwan KimSeung-Ik Ahn
Apr 19, 2017·Blood·Michele P Lambert, Terry B Gernsheimer
Jan 4, 2018·Blood·Shruti ChaturvediKeith R McCrae
Mar 29, 2018·Expert Opinion on Pharmacotherapy·Thomas Kühne
Mar 9, 2018·American Journal of Hematology·Alexandra SchifferliUNKNOWN Intercontinental Cooperative ITP Study Group (ICIS)
Apr 21, 2018·British Journal of Haematology·Sajida KaziHenry G Watson
Sep 29, 2018·American Journal of Hematology·Lauren C BylsmaJeffrey S Wasser
Feb 26, 2019·Expert Review of Clinical Immunology·Monika Długosz-DaneckaWojciech Jurczak
Dec 7, 2018·Hematology·Jenny M Despotovic, Amanda B Grimes
Jan 16, 2018·Blood Research·Jun Ho JangUNKNOWN on the behalf of Korean Aplastic Anemia Working Party
Aug 20, 2019·British Journal of Haematology·Teeraya PuavilaiAmmarin Thakkinstian
Mar 5, 2020·British Journal of Haematology·Stéphane DucassouUNKNOWN Centre de Référence National des Cytopénies Auto-immunes de l’Enfant (CEREVANCE)
Aug 23, 2019·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Charlotta EkstrandShahram Bahmanyar
Mar 29, 2019·Current Opinion in Rheumatology·Ruba Kado, W Joseph McCune
Jul 6, 2016·Current Opinion in Hematology·Adam CukerCindy E Neunert
Jun 2, 2018·Therapeutic Advances in Drug Safety·Jose Ramon Gonzalez-Porras, Jose Maria Bastida
Jul 31, 2018·Case Reports in Hematology·Hanyin Wang, Hande Tuncer
Aug 27, 2019·European Journal of Haematology·Michał WitkowskiTadeusz Robak
Jul 11, 2018·Surgical Endoscopy·Luciano TastaldiSteven Rosenblatt
Sep 18, 2018·Memo·Jan-Paul Bohn, Michael Steurer
Nov 3, 2020·Research and Practice in Thrombosis and Haemostasis·Lincy S LalAdam Cuker
Mar 7, 2021·Journal of Clinical Medicine·Anurag SinghTamam Bakchoul
May 22, 2021·Journal of Thrombosis and Haemostasis : JTH·Marina P ColellaJoyce M Annichino-Bizzacchi
Oct 11, 2021·The Medical Journal of Australia·Philip Yi ChoiRobert Bird

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