Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura

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dc.contributor.authorUğur, Mehmet Can
dc.contributor.authorBilgir, Oktay
dc.contributor.authorNamdaroğlu, Sinem
dc.contributor.authorEren, Rafet
dc.contributor.authorDoğan, Esma Evrim
dc.contributor.authorErkek, Esra Turan
dc.contributor.authorNizam, Nihan
dc.date.accessioned2023-01-12T20:32:12Z
dc.date.available2023-01-12T20:32:12Z
dc.date.issued2021
dc.departmentN/A/Departmenten_US
dc.description.abstractObjective: 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.en_US
dc.identifier.doi10.4274/tjh.galenos.2021.2021.0216
dc.identifier.endpage187en_US
dc.identifier.issn1300-7777
dc.identifier.issn1308-5263
dc.identifier.issue3en_US
dc.identifier.startpage181en_US
dc.identifier.trdizinid508926en_US
dc.identifier.urihttps://doi.org/10.4274/tjh.galenos.2021.2021.0216
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/508926
dc.identifier.urihttps://hdl.handle.net/11454/81060
dc.identifier.volume38en_US
dc.indekslendigikaynakTR-Dizinen_US
dc.language.isoenen_US
dc.relation.ispartofTurkish Journal of Hematologyen_US
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleComparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpuraen_US
dc.typeArticleen_US

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