Abstract
Immune thrombocytopenic purpura (ITP) is a common hematological disease treated primarily by corticosteroids. The aim of the present study was to compare response rate between patients, underwent splenectomy vs. rituximab as second-line therapy. Adult patients diagnosed with ITP who did not respond to corticosteroids or relapsed during the period 1990–2014 were included in a quasi-experimental study. Categorical variables were compared using Fisher exact test. Response to treatment was compared using logistic regression. Data were analyzed using SAS V9.2. One-hundred and forty-three patients with ITP were identified through medical records. Of 62 patients treated, 30 (48.38%) required second-line therapy. 19 (63%) patients received rituximab, and 11 (37%) underwent splenectomy. Platelets at diagnosis were not different between study groups (p = 0.062). Splenectomy group patients were younger (p = 0.011). Response to second-line therapy showed no significant difference between two groups (OR 2.03, 95% CI (0.21–22.09), p = 0.549). Results did not show a statistically significant difference in platelet counts over time between treatment groups (p = 0.101). When used exclusively as a second-line therapy for steroid-refractory ITP, the response rate was not statistically different between rituximab and splenectomy. However, further large studies are needed to assess the response rates for these treatment modalities as a second-line therapy.
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Acknowledgements
The authors would like to thank Department of Biostatistics and Bioinformatics at King Abdullah International Medical Research Center (KAIMRC), Riyadh for conducting the data analysis.
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Al Askar, A.S., Shaheen, N.A., Al Zahrani, M. et al. Splenectomy vs. rituximab as a second-line therapy in immune thrombocytopenic purpura: a single center experience. Int J Hematol 107, 69–74 (2018). https://doi.org/10.1007/s12185-017-2325-y
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DOI: https://doi.org/10.1007/s12185-017-2325-y