Characteristics and management of primary and other immune thrombocytopenias: Spanish registry study

Fecha de publicación: 01/09/2017

Autores de IIS La Fe

Juan Palau Bargues

Autor
Miguel Ángel Sanz Alonso

Autor

Participantes ajenos a IIS La Fe

Sancho E
Herrera M
Sánchez S
Mingot ME
Upegui RI
Rodríguez Salazar MJ
de la Cruz F
Fernández MC
González López TJ
Hernández JJ
Ríos E
López-Fernández MF
García M
Hernández JÁ

Grupos

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos

Abstract

Background: The natural history and its modulation by treatments administered for immune thrombocytopenia (ITP) in the clinical practice remains unknown. In addition, little information is available on the characteristics and management of ITP in Spain. Methods: We conducted an observational, multicenter, registry in 70 Hematology Services from Spain between 2009 and 2011, which included children from 2 months of age and adults with primary ITP or another ITP diagnosed within the last 6 months (platelet count [PC] < 100 x 10(9)/l). Patients were followed-up at 6 and 12 months. Results: 484 patients were included (median [Q1, Q3] age 52 [29,74] years, 87.6% adults), 56% women, 10.5% with secondary ITP. Median (Q1, Q3) PC at diagnosis was 12 x 10(9)/l (4, 32); 72% of patients had bleeding symptoms (62% cutaneous bleeding, 29% oral cavity bleeding, 18% epistaxis). 81% of patients with primary ITP received first-line treatment, mainly with corticosteroids (>6 weeks in 59% of cases), either alone (41%) or associated with intravenous immunoglobulin (33%). The response (>= 30 x 10(9)/L) to first-line treatment was 92%. A total of 19% of patients received second-line treatment and 6% additional treatments. At 12 months, 74% of primary ITP patients maintained a PC >= 100 x 10(9)/L in absence of treatment (10% still had hemorrhagic manifestations). Conclusions: Characteristics of Spanish ITP patients are comparable to those from other countries. Although a high response rate to first-line treatments is observed, at 1 year, the disease persists in around one quarter of patients. Overall therapeutic management in Spain conforms to current recommendations, except for an excessive duration of corticosteroids therapy.

Datos de la publicación

ISSN/ISSNe:: 1024-5332, 1607-8454
Tipo:: Article
Páginas:: 484-492
DOI:: 10.1080/10245332.2017.1311442
Factor de Impacto:: 0,475 SCImago ℠
Cuartil:: Q3 SCImago ℠

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Keywords

Immune thrombocytopenia; platelet count; response; corticosteroids; intravenous immunoglobulins

Campos de estudio

Proyectos asociados

RED DE INVESTIGACION COOPERATIVA DE CANCER

RD06/0020/0031 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006

PROYECTO CAIBER

CAI08/01/0061 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009

CREACION Y MEJORA DE INFRAESTRUCTURAS EN MEDICINA REGENERATIVA

Investigador Principal: FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA

PLE2009-0141 ACI-PLAN E . MINISTERIO DE CIENCIA E INNOVACION; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009