TY - JOUR
T1 - Relative efficacy of steroid therapy in immune thrombocytopenia mediated by anti-platelet GPIIbIIIa versus GPIbalpha antibodies
AU - Zeng, Qingshu
AU - Zhu, Lingyan
AU - Tao, Lili
AU - Bao, Jing
AU - Yang, Mingzhen
AU - Simpson, Elisa K
AU - Li, Conglei
AU - van der Wal, Evertdina
AU - Chen, Pingguo
AU - Springob, Christopher Michael
AU - Wang, Mingli
AU - Zhang, Lingjie
AU - Ruan, Changgeng
AU - Hou, Ming
AU - Xia, Ruixiang
AU - Ni, Heyu
PY - 2012
Y1 - 2012
N2 - Immune thrombocytopenia (ITP) is characterized by platelet clearance mediated primarily by autoantibodies against the platelet GPIIbIIIa and/or GPIbI?. Steroid therapy is a first-line treatment for ITP. However, some patients are refractory to this therapy and currently no method can predict which patients will respond. To evaluate whether steroids are equally efficacious in treating patients with ITP caused by anti-GPIIbIIIa versus anti-GPIbI? antibodies, we performed a retrospective study on 176 newly diagnosed patients with acute ITP who had severe bleeding symptoms and were admitted as resident patients to the hospital. The patients were treated first with intravenous administration of high-dose dexamethasone (DXM), followed by oral administration of prednisone. Response to therapy was observed in a majority of patients with antibodies specific for GPIIbIIIa (31/43) or without detectable antibodies against either GPIIbIIIa or GPIbI? (36/45). In contrast, the steroid response was significantly lower in patients with anti-GPIbI? antibodies (9/34) or with antibodies against both GPIbI? and GPIIbIIIa (16/54). The preliminary findings of this study suggest that in future prospective clinical trials including corticosteroids, the anti-GPIbI?, and -GPIIbIIIa status should be assessed in order to test its potential relevance in deciding future treatments. A? 2011 Wiley Periodicals, Inc.
AB - Immune thrombocytopenia (ITP) is characterized by platelet clearance mediated primarily by autoantibodies against the platelet GPIIbIIIa and/or GPIbI?. Steroid therapy is a first-line treatment for ITP. However, some patients are refractory to this therapy and currently no method can predict which patients will respond. To evaluate whether steroids are equally efficacious in treating patients with ITP caused by anti-GPIIbIIIa versus anti-GPIbI? antibodies, we performed a retrospective study on 176 newly diagnosed patients with acute ITP who had severe bleeding symptoms and were admitted as resident patients to the hospital. The patients were treated first with intravenous administration of high-dose dexamethasone (DXM), followed by oral administration of prednisone. Response to therapy was observed in a majority of patients with antibodies specific for GPIIbIIIa (31/43) or without detectable antibodies against either GPIIbIIIa or GPIbI? (36/45). In contrast, the steroid response was significantly lower in patients with anti-GPIbI? antibodies (9/34) or with antibodies against both GPIbI? and GPIIbIIIa (16/54). The preliminary findings of this study suggest that in future prospective clinical trials including corticosteroids, the anti-GPIbI?, and -GPIIbIIIa status should be assessed in order to test its potential relevance in deciding future treatments. A? 2011 Wiley Periodicals, Inc.
UR - http://onlinelibrary.wiley.com.ezproxy.lib.monash.edu.au/doi/10.1002/ajh.22211/abstract;jsessionid=F5B5648499E4816166B59C6BDC276378.d03t04?systemMessa
U2 - 10.1002/ajh.22211
DO - 10.1002/ajh.22211
M3 - Letter
SN - 0361-8609
VL - 87
SP - 206
EP - 208
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 2
ER -