Reemergence of Splenectomy for ITP Second-line ...
Document type :
Article dans une revue scientifique
PMID :
Permalink :
Title :
Reemergence of Splenectomy for ITP Second-line Treatment?
Author(s) :
Chater, Charbel [Auteur]
Université Lille Nord de France (COMUE)
Terriou, Louis [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Launay, David [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Chambon Jean, P [Auteur]
Provot, Francois [Auteur]
Rogosnitzky, Moshe [Auteur]
Zerbib, Philippe [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Université Lille Nord de France (COMUE)
Terriou, Louis [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Launay, David [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Chambon Jean, P [Auteur]
Provot, Francois [Auteur]
Rogosnitzky, Moshe [Auteur]
Zerbib, Philippe [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Journal title :
Annals of surgery
Abbreviated title :
Ann. Surg.
Volume number :
264
Pages :
772-777
Publication date :
2016-11-01
ISSN :
0003-4932
Keyword(s) :
splenectomy
immune thrombocytopenic purpura
Rituximab
immune thrombocytopenic purpura
Rituximab
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Introduction:
Corticosteroids are still the standard first-line treatment for immune thrombocytopenic purpura (ITP). As second-line therapy, splenectomy and Rituximab are both recommended. The aim of our study was to ...
Show more >Introduction: Corticosteroids are still the standard first-line treatment for immune thrombocytopenic purpura (ITP). As second-line therapy, splenectomy and Rituximab are both recommended. The aim of our study was to compare the efficacy of Rituximab to splenectomy in persistent or chronic ITP patients. Methods: Between January 1999 and March 2015, we retrospectively selected all consecutive patients who underwent an ITP second-line treatment: Rituximab or splenectomy. The distinction between open (OS) and laparoscopic splenectomy (LS) was analyzed. Primary outcome was composite: hospitalization for bleeding and/or thrombocytopenia and death from hemorrhage or infection. Secondary outcomes were based on response (R) and complete response (CR) rates as defined by the American Society of Hematology. Results: Ninety-six patients were included: 30 patients received Rituximab, 37 underwent OS, and 29 underwent LS. The follow-up was 30, 60, and 120 months in Rituximab, LS, and OS groups, respectively. At 30th month, the primary outcome-free survival rate was higher in splenectomy groups (84% for OS, 86% for LS) than Rituximab group (47%) (P = 0.0002). Similarly, at 30th month, R and CR rates were higher for OS (86.5% and 75.7%, respectively) and LS groups (93.1% and 89.7%) than Rituximab (46.7% and 30%) (P = 0.0001). Moreover, R rates remained elevated at 60th month for OS and LS groups (83.7% and 89.6% respectively) and 78.4% at 120th month for OS group. Conclusion: We observed that splenectomy for ITP second-line treatment was more effective than Rituximab regarding maintenance of R, CR, and overall response rates. OS and LS had similar efficacy.Show less >
Show more >Introduction: Corticosteroids are still the standard first-line treatment for immune thrombocytopenic purpura (ITP). As second-line therapy, splenectomy and Rituximab are both recommended. The aim of our study was to compare the efficacy of Rituximab to splenectomy in persistent or chronic ITP patients. Methods: Between January 1999 and March 2015, we retrospectively selected all consecutive patients who underwent an ITP second-line treatment: Rituximab or splenectomy. The distinction between open (OS) and laparoscopic splenectomy (LS) was analyzed. Primary outcome was composite: hospitalization for bleeding and/or thrombocytopenia and death from hemorrhage or infection. Secondary outcomes were based on response (R) and complete response (CR) rates as defined by the American Society of Hematology. Results: Ninety-six patients were included: 30 patients received Rituximab, 37 underwent OS, and 29 underwent LS. The follow-up was 30, 60, and 120 months in Rituximab, LS, and OS groups, respectively. At 30th month, the primary outcome-free survival rate was higher in splenectomy groups (84% for OS, 86% for LS) than Rituximab group (47%) (P = 0.0002). Similarly, at 30th month, R and CR rates were higher for OS (86.5% and 75.7%, respectively) and LS groups (93.1% and 89.7%) than Rituximab (46.7% and 30%) (P = 0.0001). Moreover, R rates remained elevated at 60th month for OS and LS groups (83.7% and 89.6% respectively) and 78.4% at 120th month for OS group. Conclusion: We observed that splenectomy for ITP second-line treatment was more effective than Rituximab regarding maintenance of R, CR, and overall response rates. OS and LS had similar efficacy.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Inserm
Université de Lille
CHU Lille
Université de Lille
CHU Lille
Collections :
Research team(s) :
Inflammatory digestive disease : pathophysiology and therapeutic targets developement
Immunity, inflammation and fibrsis in auto and allo-reactivity
Immunity, inflammation and fibrsis in auto and allo-reactivity
Submission date :
2019-03-01T15:16:49Z
2022-09-21T10:18:40Z
2022-09-21T10:18:40Z