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International Journal of Hematology

, Volume 78, Issue 5, pp 461–466 | Cite as

Idiopathic Thrombocytopenic Purpura: Better Therapeutic Responses of Patients with B- or T-Cell Clonality than Patients without Clonality

  • J. Kim
  • C. J. Park
  • H. S. Chi
  • M. J. Kim
  • J. J. Seo
  • H. N. Moon
  • T. T. Ghim
  • S. W. Kim
  • J. H. Lee
  • G. H. Lee
  • J. S. Lee
Case Report

Abstract

Results of recent studies of the pathogenesis of idiopathic thrombocytopenic purpura (ITP) have suggested activated helper T-cells drive B-lymphocytes to produce antibodies. Twenty-eight children and 85 adults with ITP entered this study. We performed polymerase chain reaction (PCR) using framework III variable region (VH FRIII)- and joining region (JH)-specific primers to analyze immunoglobulin heavy-chain gene rearrangement (IgH GR) for B-cell clonality. We used multiplex PCR to analyze T-cell receptor (TCR) γ-chain gene rearrangement (TCRγ GR) for T-cell clonality. We diagnosed 10 cases as acute ITP and 97 cases as chronic ITP. The IgH GR result was positive in 77.8% of the acute-form cases and in 58.8% of the chronic-form cases. The TCRγ GR result was positive in 11.1% of the acute cases and in 10.6% of the chronic cases. There was no dif-ference in frequency of clonality between the acute and chronic forms. After treatment the platelet count normalized in 81.8% (36/44) of the chronic ITP cases with B-cell clonality and in 88.9% (8/9) of the chronic ITP cases with T-cell clonality, compared with a normalized platelet count in 46.2% (12/26) of the chronic ITP cases without clonality. The patients with T- or B-cell clonality appeared to have better therapeutic responses than patients without clonality. In conclusion,T- and B-cell clonality may play a positive role in determining therapeutic response.

Key words

Idiopathic thrombocytopenic purpura Immunoglobulin heavy-chain gene rearrangement T-cell receptor γ-chain gene rearrangement Therapeutic response 

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Copyright information

© The Japanese Society of Hematology 2003

Authors and Affiliations

  • J. Kim
    • 1
  • C. J. Park
    • 1
  • H. S. Chi
    • 1
  • M. J. Kim
    • 1
  • J. J. Seo
    • 2
  • H. N. Moon
    • 2
  • T. T. Ghim
    • 2
  • S. W. Kim
    • 3
  • J. H. Lee
    • 3
  • G. H. Lee
    • 3
  • J. S. Lee
    • 3
  1. 1.Department of Laboratory MedicineAsan Medical Center and University of Ulsan College of MedicineSeoulKorea
  2. 2.Department of PediatricsAsan Medical Center and University of Ulsan College of MedicineSeoulKorea
  3. 3.Department of Hemato-oncologyAsan Medical Center and University of Ulsan College of MedicineSeoulKorea

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