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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

2001; Wiley; Volume: 66; Issue: 3 Linguagem: Inglês

10.1002/1096-8652(200103)66

1096-8652

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,

Renal Diseases and Glomerulopathies

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, 150 × 109/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.