Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura
Yıl: 2021 Cilt: 38 Sayı: 3 Sayfa Aralığı: 181 - 187 Metin Dili: İngilizce DOI: 10.4274/tjh.galenos.2021.2021.0216 İndeks Tarihi: 25-05-2022
Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura
Öz: Objective: Primary immune thrombocytopenia (ITP) is an acquired
autoimmune disease characterized by isolated thrombocytopenia.
While first-line treatments focus on inhibiting autoantibodies and
platelet destruction, second- and third-line treatments include
splenectomy and thrombopoietin receptor agonists. In this study, we
aimed to compare the efficiency and toxicities of splenectomy and
eltrombopag as second-line treatments in ITP.
Materials and Methods: We retrospectively analyzed patients who
were diagnosed with ITP and followed between 2015 and 2020. Patients
who underwent splenectomy or received eltrombopag treatment as
second-line or further therapy were included. For subgroup analyses,
patients were further stratified according to whether they received
eltrombopag in the second or third line of treatment.
Results: There were 38 patients in the splenectomy group and 47 patients
in the eltrombopag group. The mean age of patients in the splenectomy
and eltrombopag groups was 43.2 and 50.5 years, respectively. Time to
response was significantly shorter in the splenectomy arm (p=0.001).
However, response rates at the 3 rd, 6 th, 12 th, and 24 th months did not
exhibit a statistically significant difference between groups; nor did
total duration of response and adverse events. Response rates at the
1st, 3rd, 6th, 12th, and 24th months and the total duration of response did
not exhibit a statistically significant difference between eltrombopag
subgroups. Eltrombopag treatment was ceased for 20 patients after a
median of 54.1 months (range: 1-151). Among them, 12 patients (60%)
did not experience a loss of response.
Conclusion: Comparing the splenectomy and eltrombopag arms, even
though time to achieve response was in favor of the splenectomy
group, this advantage disappeared when overall response rates and
response rate at the 2 nd year were considered. Using eltrombopag in
the second or third line of therapy does not yield any difference in
terms of time to achieving response.
Anahtar Kelime: İmmün Trombositopenik Purpuranın İkinci Basamak Tedavisinde Splenektomi ve Eltrombopag Tedavilerinin Karşılaştırılması
Öz: Amaç: Primer immün trombositopeni (İTP), izole trombositopeni ile
karakterize, edinsel bir otoimmün hastalıktır. Birinci basamak tedaviler
otoantikorları ve trombosit yıkımını inhibe etmeye odaklanırken,
ikinci ve üçüncü basamak tedaviler arasında splenektomi ve
trombopoietin reseptör agonistleri bulunur. Bu çalışmada, İTP’de ikinci
basamak tedaviler olarak splenektomi ve eltrombopagın etkinlik ve
toksisitelerinin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntemler: 2015-2020 yılları arasında İTP tanısı alan ve
takip edilen hastaları retrospektif olarak analiz ettik. Splenektomi
yapılan ve 2. veya daha ileri basamaklarda eltrombopag tedavisi alan
hastalar çalışmaya dahil edildi. Alt grup analizleri için, hastalar ikinci
veya üçüncü tedavi hattında eltrombopag alıp almadıklarına göre
gruplandırıldı.
Bulgular: Splenektomi grubunda 38 hasta, eltrombopag grubunda
47 hasta vardı. Splenektomi ve eltrombopag gruplarındaki hastaların
ortalama yaşı sırasıyla 43,2 ve 50,5’di. Splenektomi kolunda yanıt
süresi anlamlı olarak daha kısaydı (p=0,001). Bununla birlikte, 3., 6.,
12. ve 24. aylardaki yanıt oranları, toplam yanıt süresi ve yan etkiler
açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmadı.
Birinci, 3., 6., 12. ve 24. aylardaki yanıt oranları ve toplam yanıt süresi,
eltrombopag alt grupları arasında istatistiksel olarak anlamlı değildi.
Eltrombopag tedavisi medyan 54,1 ay (1-151) sonra 20 hastada kesildi.
Bunlardan 12 hastada (%60) yanıt kaybı yaşanmadı.
Sonuç: Splenektomi ve eltrombopag kolları karşılaştırıldığında yanıt
alma süresi splenektomi lehine olsa da, genel yanıt oranları ve 2. yıldaki
yanıt oranları dikkate alındığında bu avantaj ortadan kalkmaktadır.
İkinci veya 3. basamak tedavide eltrombopag kullanılması, yanıt alma
süresi açısından herhangi bir fark oluşturmamaktadı
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA | UĞUR M, NAMDAROGLU S, Dogan E, ERKEK E, NİZAM N, EREN R, Bilgir O (2021). Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. , 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
Chicago | UĞUR Mehmet Can,NAMDAROGLU SİNEM,Dogan Esma Evrim,ERKEK Esra Turan,NİZAM Nihan,EREN RAFET,Bilgir Oktay Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. (2021): 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
MLA | UĞUR Mehmet Can,NAMDAROGLU SİNEM,Dogan Esma Evrim,ERKEK Esra Turan,NİZAM Nihan,EREN RAFET,Bilgir Oktay Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. , 2021, ss.181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
AMA | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. . 2021; 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
Vancouver | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. . 2021; 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
IEEE | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O "Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura." , ss.181 - 187, 2021. 10.4274/tjh.galenos.2021.2021.0216 |
ISNAD | UĞUR, Mehmet Can vd. "Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura". (2021), 181-187. https://doi.org/10.4274/tjh.galenos.2021.2021.0216 |
APA | UĞUR M, NAMDAROGLU S, Dogan E, ERKEK E, NİZAM N, EREN R, Bilgir O (2021). Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. Turkish Journal of Hematology, 38(3), 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
Chicago | UĞUR Mehmet Can,NAMDAROGLU SİNEM,Dogan Esma Evrim,ERKEK Esra Turan,NİZAM Nihan,EREN RAFET,Bilgir Oktay Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. Turkish Journal of Hematology 38, no.3 (2021): 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
MLA | UĞUR Mehmet Can,NAMDAROGLU SİNEM,Dogan Esma Evrim,ERKEK Esra Turan,NİZAM Nihan,EREN RAFET,Bilgir Oktay Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. Turkish Journal of Hematology, vol.38, no.3, 2021, ss.181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
AMA | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. Turkish Journal of Hematology. 2021; 38(3): 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
Vancouver | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura. Turkish Journal of Hematology. 2021; 38(3): 181 - 187. 10.4274/tjh.galenos.2021.2021.0216 |
IEEE | UĞUR M,NAMDAROGLU S,Dogan E,ERKEK E,NİZAM N,EREN R,Bilgir O "Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura." Turkish Journal of Hematology, 38, ss.181 - 187, 2021. 10.4274/tjh.galenos.2021.2021.0216 |
ISNAD | UĞUR, Mehmet Can vd. "Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura". Turkish Journal of Hematology 38/3 (2021), 181-187. https://doi.org/10.4274/tjh.galenos.2021.2021.0216 |