Study of platelet kinetics in immune thrombocytopenia to predict splenectomy response,British Journal of Haematology

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Study of platelet kinetics in immune thrombocytopenia to predict splenectomy response
British Journal of Haematology ( IF 5.1 ) Pub Date : 2023-10-11 , DOI: 10.1111/bjh.19145
Ana Mendoza ₁ , María Teresa Álvarez-Román _{1,

2,

3} , Elena Monzón-Manzano _{1,

2} , Paula Acuña _{1,

2} , Elena G Arias-Salgado _{1,

2} , Isabel Rivas-Pollmar _{1,

2} , Mónica Martín-Salces _{1,

2} , Bárbara Martínez de Miguel ₄ , Elena Martínez Montalbán ₄ , Víctor Jiménez-Yuste _{1,

2,

3} , Nora Butta _{1,

2}

Affiliation

Despite the efficacy of splenectomy for chronic immune thrombocytopenia (ITP), its considerable failure rate and its possible related complications prove the need for further research into potential predictors of response. The platelet sequestration site determined by ¹¹¹In-labelled autologous platelet scintigraphy has been proposed to predict splenectomy outcome, but without standardisation in clinical practice. Here, we conducted a single-centre study by analysing a cohort of splenectomised patients with ITP in whom ¹¹¹In-scintigraphy was performed at La Paz University Hospital in Madrid to evaluate the predictive value of the platelet kinetic studies. We also studied other factors that could impact the splenectomy outcome, such as patient and platelet characteristics. A total of 51 patients were splenectomised, and 82.3% responded. The splenic sequestration pattern predicted a higher rate of complete response up to 12 months after splenectomy (p = 0.005), with 90% sensitivity and 77% specificity. Neither age, comorbidities, therapy lines nor previous response to them showed any association with response. Results from the platelet characteristics analysis revealed a significant loss of sialic acid in platelets from the non-responding patients compared with those who maintained a response (p = 0.0017). Our findings highlight the value of splenic sequestration as an independent predictor of splenectomy response.

中文翻译：

免疫性血小板减少症中血小板动力学研究预测脾切除反应

尽管脾切除术对慢性免疫性血小板减少症（ITP）有效，但其相当大的失败率及其可能的相关并发症证明需要进一步研究潜在的反应预测因素。已提出通过¹¹¹ In 标记的自体血小板闪烁扫描确定血小板封存位点来预测脾切除结果，但在临床实践中尚未标准化。在这里，我们进行了一项单中心研究，通过分析一组脾切除的 ITP 患者，在马德里拉巴斯大学医院对这些患者进行了¹¹¹ In 闪烁扫描，以评估血小板动力学研究的预测价值。我们还研究了可能影响脾切除结果的其他因素，例如患者和血小板特征。共有 51 名患者接受了脾切除，82.3% 有反应。脾隔离模式预测脾切除后长达 12 个月的完全缓解率较高 ( p = 0.005)，敏感性为 90%，特异性为 77%。年龄、合并症、治疗方案以及之前对它们的反应均未显示与反应有任何关联。血小板特征分析结果显示，与保持反应的患者相比，无反应患者的血小板中唾液酸显着减少（ p = 0.0017）。我们的研究结果强调了脾隔离作为脾切除反应的独立预测因子的价值。

更新日期：2023-10-11

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