A Retrospective Analysis of Newly Diagnosed ITP Patients to Analyze Response to First and Further Line Treatments.

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Date

2023-03

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Addis Ababa University

Abstract

Background Primary immune thrombocytopenia (ITP) is a relatively uncommon hematologic disorder with an estimated incidence of 3 to 6 patients /100,000 per year in the West. Initial response rates to corticosteroids average at 70%. In our country data on patient characteristics and outcome of therapy are scarce. Objective The primary objective of this study is to determine the rate of initial response to corticosteroids in newly diagnosed ITP patients. Secondary objectives include duration of response, associations between independent/patient variables and response, duration of PDN therapy and outcomes with further line treatments. Method: This is a retrospective, single-center study conducted at Tikur Anbessa Specialized Hospital, a tertiary care hospital located in Addis Ababa. All newly diagnosed ITP patients for whom adequate information regarding their outcome after 1st line therapy was available were included in this study. Data obtained thru a standardized questioner was analyzed by IBM-IPSS version 20 statistical software. Result: A total of 48 study participants with the age of 18 & above were included in the study. Females constitute 85% of the participants. 63% of the patients are less than 35 years old. The mean and range of age are 34 Yrs and 17 Yrs – 52 Yrs. 62 % had an initial response to steroids (52% complete response). The rate of SR at 6 months was 68%, a statistically significant difference from previous reports (P-value < 0.0001< , with a 95% C.I. = 0.4544 - 0.7856). Rituximab and prednisolone were the most frequently used 2nd line drugs. 6 patients were splenectomized. Patients with a response to 1st line prednisolone had a marginally significant better outcome with 2nd /3rd line rituximab Conclusion: Initial response rate to steroids was in line with previous studies done elsewhere. The SR rate was 68% that is significantly more than that reported in previous studies of 1st line prednisolone therapy in newly diagnosed ITP patients.

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Keywords

Primary immune, Thrombocytopenia

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