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Response to high‐dose intravenous immune globulin as a valuable factor predicting the effect of splenectomy in chronic idiopathic thrombocytopenic purpura patients
Author(s) -
Choi Chul Won,
Kim Byung Soo,
Seo Jae Hong,
Shin Sang Won,
Kim Yeul Hong,
Kim Jun Suk,
Sohn Sang Kyun,
Kim Jae Seok,
Shin Dong Gun,
Ryoo Hun Mo,
Lee Kyung Hee,
Lee Je Jung,
Chung Ik Joo,
Kim Hyeoung Joon,
Kwak Jae Yong,
Yim Chang Yeol,
Ahn Jin Seok,
Lee Jung Ae,
Park Young Suk
Publication year - 2001
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/1096-8652(200103)66:3<197::aid-ajh1044>3.0.co;2-6
Subject(s) - splenectomy , medicine , thrombocytopenic purpura , gastroenterology , immune system , platelet , immunology , spleen
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 × 10 9 /l), incomplete response (IR, (50–150) × 10 9 /l), and complete response (CR, >150 × 10 9 /l). 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. Am. J. Hematol. 66:197–202, 2001. © 2001 Wiley‐Liss, Inc.