title: Outpatient Management of Patients with Immune Thrombocytopenia (ITP) by Hematologists 1995-2014.
abstract: BACKGROUND
  The aim of this study was to evaluate the treatment reality for outpatients with immune thrombocytopenia (ITP) managed by hematologists in routine care.
  
  
  METHODS
  All patients with ITP diagnosed between 06/1995 and 12/2014 in a community-based oncology group practice in Germany were retrospectively analyzed.
  
  
  RESULTS
  422 patients with a median age of 55 years (range 7-91 years) were evaluated. 57% were female and 43% male. Only 198 (47%) patients needed therapy. First-line therapy (n = 198) consisted of steroids in 81%, intravenous immunoglobulins (IVIG) in 12%, and IVIG plus steroids in 6%. Patients received a median of 2 (range 1-10) lines of therapy. The most frequently used treatment modalities were steroids in 93%, IVIG in 55%, splenectomy in 21%, and other immunosuppressive agents (OISA) in 23% of patients. Rituximab and thrombopoietin receptor agonists (TRAs) were used in 10% and 6% only. 9 (2%) patients needed hospitalization due to bleeding complications. 72% of patients achieved a durable remission after their last line of therapy. 1 (0.2%) patient died due to bleeding complications.
  
  
  CONCLUSIONS
  The treatment modalities most frequently used are steroids, immunoglobulins, splenectomy, and OISA. Rituximab and TRAs are only used infrequently. 72% of ITP patients achieve durable remissions. The rate of hospital admissions due to bleeding complications and the ITP-related mortality are low. The majority of ITP patients can be safely managed by hematologists on an outpatient basis.
authors.affiliation: Praxisklinik fx00FC;r Hx00E4;matologie und Onkologie, Koblenz, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Weide
authors.forename: Stefan
authors.initials: S
authors.lastname: Feiten
authors.forename: Vera
authors.initials: V
authors.lastname: Friesenhahn
authors.forename: Jochen
authors.initials: J
authors.lastname: Heymanns
authors.forename: Kristina
authors.initials: K
authors.lastname: Kleboth
authors.forename: Jörg
authors.initials: J
authors.lastname: Thomalla
authors.forename: Christoph
authors.initials: C
authors.lastname: van Roye
authors.forename: Hubert
authors.initials: H
authors.lastname: Köppler
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006405:Hematology / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013156:Splenectomy / Q000401:mortality*; D013256:Steroids / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome; D014600:Utilization Review; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids