title: Evaluation of 143 cases of immune thrombocytopenic purpura with regards to clinical course and response to treatment.
abstract: OBJECTIVE
  Immune thrombocytopenic purpura (ITP) is also known as idiopathic thrombocytopenic purpura. Increased platelet destruction and insufficient platelet production are both responsible for its etiopathogenesis. ITP can be diagnosed after excluding other possible causes of thrombocytopenia.
  
  
  METHODS
  One hundred forty-three cases of chronic ITP that were monitored in a hematology clinic were retrospectively evaluated. All cases received first line treatment of 1 mg/kg/day prednisolone. Corticosteroid nonresponsive (CN) cases and corticosteroid-dependent (CD) cases underwent splenectomies.
  
  
  RESULTS
  The rate of CN/CD cases was found to be 53% (n=76). Sixty-six percent of these cases (n=50) underwent splenectomies. The ratio of non-responsive cases to relapse cases after splenectomy (SN/SR) was 30% (n=15). The total number of cases was 41, including those without splenectomy (n=26) and with SY/SR (n=15). Helicobacter pylori (Hp) eradication, immunosuppressive agents and danazol treatments were administered to patients (n=10, n=14 and n=4, respectively). Currently, 13 patients are being monitored without treatment. Fifteen patients who were non-responsive to Hp eradication treatment, immunosuppressive treatment or danazol treatment are still being monitored without any treatment.
  
  
  CONCLUSIONS
  Optimal treatment is not available for splenectomy-resistant cases of ITP. The response rates for Hp eradication treatment, immunosuppressive treatments and anabolic agents are low. Therefore, larger studies with more patients are required using new agents, such as thrombopoietin (TPO) receptor agonists and anti-CD20 monoclonal antibodies.
authors.affiliation: Department of Hematology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Albayrak
authors.affiliation: Department of Hematology, Medical School, Fatih University, Ankara, Turkey.
authors.forename: Ozlem Sahin
authors.initials: OS
authors.lastname: Balcik
authors.affiliation: Department of Hematology, Medical School, Gazi University, Ankara, Turkey.
authors.forename: Sahika Zeynep
authors.initials: SZ
authors.lastname: Aki
authors.affiliation: Department of Hematology, Medical School, Zonguldak Karaelmas University, Zonguldak, Turkey.
authors.forename: Ayla
authors.initials: A
authors.lastname: Gokmen
authors.affiliation: Department of Hematology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Ceran
authors.affiliation: Department of Hematology, Istanbul Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Yokus
authors.affiliation: Department of Hematology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Simten
authors.initials: S
authors.lastname: Dagdas
authors.affiliation: Department of Hematology, Medical School, Ufuk University, Ankara, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Ayli
authors.affiliation: Department of Hematology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Gulsum
authors.initials: G
authors.lastname: Ozet
keywords: Anti-CD20 monoclonal antibodies; Immune thrombocytopenic purpura; Splenectomy; Thrombopoietin (TPO) receptor agonists