Comparison of treatment regimens used in patients diagnosed with idiopathic thrombocytopenic purpura

Abstract EN

Objective: To compare the efficacy of different treatment regimens used in patients diagnosed with Idiopathic Thrombocytopenic Purpura, also called primary Immune Thrombocytopenia (ITP).

Methodology: Retrospective cross-sectional design used.

83 patients followed in hematology clinic at King Hussein Medical Center as Idiopathic Thrombocytopenic Purpura cases were included.

Treatment options were classified as first, second and third lines.

Treatment response defined according to The American Society of Hematology.

Results: Eighty three patients diagnosed with Idiopathic Thrombocytopenic Purpura, the median age was 30 years (18-70) and platelet count < 30,000/ µl.

Majority of them were female (63.9%).

Overall response rate (Partial Response and Complete Response) with first line therapy Prednisone was 90.4% (75/83), while response rate for those given second line Azathioprine and Danazol was 35.7% (17/49) and 57.1% (4/7) respectively.

Moreover third line treatment response rate was as follow, Mycophenolate 31% (9/29), Rituximab 50% (7/14), and Splenectomy 70% (7/10).

Out of 75 patients who responded to Prednisone, 35 patients were dependent on steroid and shifted to second line therapy.

The results revealed statistically significant difference in treatment response at first and third month of treatment induction (p value = .001 and .032 respectively).

Only three patients remained refractory to Splenectomy and to all used treatments.

Conclusion: Idiopathic Thrombocytopenic Purpura is an acquired bleeding disorder with complex pathophysiology.

More than 50% of patients who responded to Prednisone therapy developed dependency; however it is effective treatment for Idiopathic Thrombocytopenic Purpura.

Rituximab showed efficacy that is nearly equal to splenectomy which is still the treatment of choice for cases with steroid resistance