Response to high-dose intravenous immune globulin as a valuable factor predicting the effect of splenectomy in chronic idiopathic thrombocytopenic purpura patients

Chul Won Choi, Byung Soo Kim, Jae Hong Seo, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim, Sang Kyun Sohn, Jae Seok Kim, Dong Gun Shin, Hun Mo Ryoo, Kyung Hee Lee, Je Jung Lee, Ik Joo Chung, Hyeoung Joon Kim, Jae Yong Kwak, Chang Yeol Yim, Jin Seok Ahn, Jung Ae Lee, Young Suk Park

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Abstract

This study was conducted to verify whether the response to high-dose intravenous immune globulin (IVIG) was related to the effect of splenectomy in chronic idiopathic thrombocytopenic purpura (ITP) patients. A total of 79 patients over 16 years of age were enrolled in this study. The response to the treatment was classified on the basis of the platelet count as no response (NR, <50 × 109/I), incomplete response (IR, (50-150) × 109/I), and complete response (CR, >150 × 109/I). The response was evaluated after the infusion of high-dose IVIG, within 2 weeks after splenectomy (immediate response), and during a follow-up period of more than 6 months after splenectomy (sustained response), respectively. 58 patients (73.4%) showed responses (CR or IR) to high-dose IVIG. After splenectomy, immediate responses were observed in 73 patients (92%). The response to high-dose IVIG had no relationship with the immediate response to splenectomy (P = 0.333). A follow-up evaluation was possible with 58 patients; 6 patients with NR in immediate responses did not show any response during the follow-up period, and 17 patients relapsed within 6 months after immediate responses, so 35 patients (60.3%) had sustained responses. Responders to IVIG had significantly higher sustained response rates to splenectomy than non-responders (62% vs. 38%, P = 0.001). These results indicate that the response to high-dose IVIG could be a valuable factor predicting the sustained response to splenectomy in chronic ITP patients.

Original languageEnglish
Pages (from-to)197-202
Number of pages6
JournalAmerican Journal of Hematology
Volume66
Issue number3
DOIs
Publication statusPublished - 2001 Mar 3

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Keywords

  • High-dose immune globulin
  • Idiopathic thrombocytopenic purpura (ITP)
  • Splenectomy

ASJC Scopus subject areas

  • Hematology

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