Title :

Splenectomy for primary immune thrombocytopenia revisited in the era of thrombopoietin receptor agonists: New insights for an old treatment.

Author(s) :

Mageau, Arthur [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Terriou, Louis [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Ebbo, Mikael [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Souchaud-Debouverie, Odile [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Orvain, Corentin [Auteur]
Innate Immunity and Immunotherapy [CRCINA-ÉQUIPE 7]
Graveleau, Julie [Auteur]
Centre hospitalier de Saint-Nazaire
Lega, Jean-Christophe [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Ruivard, Marc [Auteur]
CHU Estaing [Clermont-Ferrand]
Viallard, Jean-François [Auteur]
Université de Bordeaux [UB]
Cheze, Stéphane [Auteur]
Laboratoire d'Hématologie Biologique [CHU Caen]
Dossier, Antoine [Auteur]
CIC - CHU Bichat
Bonnotte, Bernard [Auteur]
Centre de référence des maladies rares des cytopénies auto-immunes de l'adulte (CHU Dijon) [CRMR des cytopénies auto-immunes de l'adulte ]
Perlat, Antoinette [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Gobert, Delphine [Auteur]
Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] [I3]
Costedoat-Chalumeau, Nathalie [Auteur]
Centre de référence des maladies auto-immunes systémiques rares d'Île-de-France / National Reference Center for Rare Systemic Autoimmune Diseases
Jeandel, Pierre-Yves [Auteur]
Université Nice Sophia Antipolis (1965 - 2019) [UNS]
Dernoncourt, Amandine [Auteur]
Université de Picardie Jules Verne [UPJV]
Michel, Marc [Auteur]
Godeau, Bertrand [Auteur]
Institut Mondor de Recherche Biomédicale [IMRB]
Comont, Thibault [Auteur]
Service Hématologie - IUCT-Oncopole [CHU Toulouse]

Journal title :

American Journal of Hematology

Abbreviated title :

Am J Hematol

Volume number :

97

Pages :

10-17

Publication date :

2021-10-28

ISSN :

1096-8652

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Although splenectomy is still considered the most effective curative treatment for immune thrombocytopenia (ITP), its use has significantly declined in the last decade, especially since the approval of thrombopoietin ...
Show more >Although splenectomy is still considered the most effective curative treatment for immune thrombocytopenia (ITP), its use has significantly declined in the last decade, especially since the approval of thrombopoietin receptor agonists (TPO-RAs). The main objective of the study was to determine whether splenectomy was still as effective nowadays, particularly for patients with failure to respond to TPO-RAs. Our secondary objective was to assess, among patients who relapsed after splenectomy, the pattern of response to treatments used before splenectomy. This multicenter retrospective study involved adults who underwent splenectomy for ITP in France from 2011 to 2020. Response status was defined according to international criteria. We included 185 patients, 100 (54.1%) and 135 (73.0%) patients had received TPO-RAs and/or rituximab before the splenectomy. The median follow-up after splenectomy was 39.2 months [16.5–63.0]. Overall, 144 (77.8%) patients had an initial response and 23 (12.4%) experienced relapse during follow-up, for an overall sustained response of 65.4%, similar to that observed in the pre-TPO-RA era. Among patients who received at least one TPO-RA or rituximab before splenectomy, 92/151 (60.9%) had a sustained response. Six of 13 (46%) patients with previous lack of response to both TPO-RAs and rituximab had a sustained response to splenectomy. Among patients with relapse after splenectomy, 13/21 (61.2%) patients responded to one TPO-RAs that failed before splenectomy. In conclusion, splenectomy is still a relevant option for treating adult primary ITP not responding to TPO-RAs and rituximab. Patients with lack of response or with relapse after splenectomy should be re-challenged with TPO-RAs.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T05:50:18Z
2024-01-29T08:21:35Z