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- Title
Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura.
- Authors
Houwerzijl, Ewout J.; Louwes, Henk; Sluiter, Wim J.; Smit, Jan W.; Vellenga, Edo; de Wolf, Joost Th. M.
- Abstract
The predictive value of clinical and platelet kinetic parameters for treatment outcome in idiopathic thrombocytopenic purpura (ITP) was investigated in 75 patients with platelets ≤20 × 109/L. The platelet kinetic studies showed that the platelet production rate (PPR) was decreased (<100 × 109/day), normal, or increased (>355 × 109/day) in 33%, 48%, and 19% of patients, respectively. All patients started with prednisone at diagnosis (1 mg/kg/day). Initial complete and partial response (CR/PR) rate was 84% and a durable CR/PR (≥6 months without treatment) was attained in 44% of the patients. Durable CR/PR was noticed in 64% of the patients with decreased PPR during a median follow-up time without treatment of 81 (range 18–92) months, compared to 34% of the patients with normal or increased PPR during a median follow-up time without treatment of 141 (range 10–284) months ( p = 0.03). Splenectomy was performed in 32% of patients with decreased PPR and in 62% of patients with normal or increased PPR ( p = 0.03). In conclusion, ITP patients with suppressed PPR have a significant higher durable CR/PR rate to prednisone therapy and are less frequently exposed to splenectomy than those with a normal or increased PPR.
- Subjects
PREDNISONE; THROMBOCYTOPENIA; BLOOD platelet disorders; SPLENECTOMY; BLOOD platelets
- Publication
Annals of Hematology, 2008, Vol 87, Issue 12, p975
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-008-0537-1