Retrospective analysis of patients with idiopathic thrombocytopenic purpura from Eastern Anatolia.
OBJECTIVE
We evaluated the clinical features and the effects of various treatment modalities on the clinical course in patients diagnosed with idiopathic thrombocytopenic purpura (ITP).


METHODS
Retrospective investigation of the medical records of 168 patients at our center between 1994 and 2005 was done.


RESULTS
Of the 168 patients, 115 (68.4%) were women and 53 (31.6%) men. At initial diagnosis, the median age of the patients was 33 years (range: 15-91) and 139 (82.7%) had signs of bleeding. Follow-up was complete in 130 patients and the median follow-up was 27 months (range: 3-132). Initial treatment with either standard or high-dose steroid as first-line therapy was begun in 123 (73.2%) of the 168 patients. Complete remission (CR) was achieved in 56% of the patients. Sixty-one (61) patients who were followed up regularly received second-line therapies. CR was achieved in 45.8% of the patients who received steroids as second-line therapy. Within a median follow-up of 7 months, 27.2% of these patients relapsed. Splenectomy was performed in 26 patients and CR was obtained in 72% of the 25 patients regularly followed up. CR obtained by splenectomy was significantly higher than that obtained by steroids (p < 0.001). The 10-year disease-free survivals in patients who used steroids and who underwent splenectomy were 15 and 61.6%, respectively.


CONCLUSIONS
Steroid therapy is effective both in the initial and relapse periods. Splenectomy is the treatment of choice for those ITP patients refractory to steroid therapy and younger than 40 years of age.
Kaya
Emin
E
Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey. ekaya@inonu.edu.tr
Erkurt
Mehmet Ali
MA
Aydogdu
Ismet
I
Kuku
Irfan
I
Ozhan
Onur
O
Oner
Ramazan Ilyas
RI
Ulutas
Ozkan
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D013156:Splenectomy; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
D007166:Immunosuppressive Agents; D013256:Steroids