International Journal of Hematology

, Volume 107, Issue 1, pp 69–74 | Cite as

Splenectomy vs. rituximab as a second-line therapy in immune thrombocytopenic purpura: a single center experience

  • Ahmed S. Al Askar
  • Naila A. Shaheen
  • Mohsen Al Zahrani
  • Mohammed G. Al Otaibi
  • Bader S. Al Qahtani
  • Faris Ahmed
  • Mohand Al Zughaibi
  • Ismat Kamran
  • May Anne Mendoza
  • Altaf Khan
Original Article

Abstract

Immune thrombocytopenic purpura (ITP) is a common hematological disease treated primarily by corticosteroids. The aim of the present study was to compare response rate between patients, underwent splenectomy vs. rituximab as second-line therapy. Adult patients diagnosed with ITP who did not respond to corticosteroids or relapsed during the period 1990–2014 were included in a quasi-experimental study. Categorical variables were compared using Fisher exact test. Response to treatment was compared using logistic regression. Data were analyzed using SAS V9.2. One-hundred and forty-three patients with ITP were identified through medical records. Of 62 patients treated, 30 (48.38%) required second-line therapy. 19 (63%) patients received rituximab, and 11 (37%) underwent splenectomy. Platelets at diagnosis were not different between study groups (p = 0.062). Splenectomy group patients were younger (p = 0.011). Response to second-line therapy showed no significant difference between two groups (OR 2.03, 95% CI (0.21–22.09), p = 0.549). Results did not show a statistically significant difference in platelet counts over time between treatment groups (p = 0.101). When used exclusively as a second-line therapy for steroid-refractory ITP, the response rate was not statistically different between rituximab and splenectomy. However, further large studies are needed to assess the response rates for these treatment modalities as a second-line therapy.

Keywords

ITP Second-line therapy Immune thrombocytopenic purpura Rituximab Splenectomy 

Notes

Acknowledgements

The authors would like to thank Department of Biostatistics and Bioinformatics at King Abdullah International Medical Research Center (KAIMRC), Riyadh for conducting the data analysis.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Ahmed S. Al Askar
    • 1
    • 2
    • 3
  • Naila A. Shaheen
    • 2
    • 3
  • Mohsen Al Zahrani
    • 1
    • 2
  • Mohammed G. Al Otaibi
    • 3
  • Bader S. Al Qahtani
    • 3
  • Faris Ahmed
    • 3
  • Mohand Al Zughaibi
    • 3
  • Ismat Kamran
    • 2
    • 3
  • May Anne Mendoza
    • 2
    • 3
  • Altaf Khan
    • 2
    • 3
  1. 1.Division of Adult Hematology and SCT, King Abdulaziz Medical CityNational Guard Health AffairsRiyadhKingdom of Saudi Arabia
  2. 2.King Abdullah International Medical Research CenterRiyadhKingdom of Saudi Arabia
  3. 3.King Saud Bin Abdulaziz University for Health SciencesRiyadhKingdom of Saudi Arabia

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