Retrospective analysis of idiopathic thrombocytopenia purpura (itp) cases in southeastern anatolia, followed in hematology department of Gaziantep Medical Faculty; 10 years' experience

Introduction-Aims: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by thrombocytopenia due to destruction of thrombocytes in reticuloendothelial system; mainly in spleen by antiplatelet antibodies. Frequently appears on children and young adults as well as in women (3:1). In chronic ITP, severe bleeding is usually not visible unless platelet count diminishes less than 10x109/L. Materials And Methods: 204 eligible ITP cases were included in this retrospective study, at the Hematology Department of Gaziantep University Research Hospital, between 2002 and 2012. Patients were grouped according to requirement of treatment and type of response to treatment. Platelet count between 30x109/L and 100x109/L was considered as partially responsive and above 100x109/L was considered as fully responsive. Findings: 141(70%) of the 204 chronic ITP patients were female and 63(30%) them were male. Patients in this study were referred to our clinic with the symptoms; dermal, mucosal bleeding and intracranial hemorrhage were observed in 121, 83 and 1 patients; respectively. 173 patients, initial therapy was 1 mg/kg methyl prednisolone (MPRD) for 3.5 mounts time period. With this treatment, 69 patients (42.3%) showed complete response, 78 (47.8%) were partially responsive and 16 (9.8%) was resistant. Within 2-6 months later recurrence was observed in 81 patients (48,2%) with complete remission. Splenectomy was performed 94 of 73 patients without complete remission. After splenectomy number of 51 patients (69.9%) had complete response, 16 (21.9%) had partial remission and 6 (8.2%) were unresponsive. As an immunosuppressive treatment to 8 (3.9%) patients; vincristine, to 13(6.7%) cyclosporine, to 10 (4.9 %) Eltrombopag, to 6 (2.4%) rituximab and to 8 (3.92%) other agents danazol azathioprine) are given. Complete remission is achived in 5 (62.5%) patients receiving vincristine, 7 (53.8%) patients receiving cyclosporine and 5 (50%) patients receiving eltrombopag. Results: As a result of this study, as initial therapy prednisone and splenectomy was found to be effective in the majority of cases of ITP and in patients with refractory ITP, vincristine, cyclosporine, and Eltrombopag was concluded to be effective. Key Words: Idiopathic thrombocytopenic purpura, Prednisolone, splenectomy, Eltrombopag, Immunosuppressive therapy