The effects of corticosteroid treatment on immune thrombocytopenia under new diagnostic criteria / 中华内科杂志

ABSTRACT

Objective To address the standard first-line management under the new diagnostic criteria in adult immune thrombocytopenia (ITP). Methods A retrospective analysis was conducted involving 178 adult ITP patients treated with high-dose dexamethasone or prednisone in Qilu Hospital from March 2004 to November 2009 using new diagnostic criteria. Results The median age was 41 years with a male/female ratio of 0. 73 1. Among the 178 ITP patients, 87 were newly diagnosed, 30 persistent ITP, 58 chronic ITP, and 3 unable to follow up. The efficacy rates among 167 patients able to assess in the three groups were 77.4% ( 65/84 ), 64. 0% ( 16/25 ) and 62. 1% ( 36/58 ) respectively, and their complete remission (CR) rates were 57. 1% (48/84), 36. 0% (9/25) and 32. 8% (19/58). The efficacy rate and CR rate of the newly diagnosed ITP category were significantly higher than those of the chronic ITP category (x2 = 3. 917, P ＜ 0. 05 ;x2 = 8. 186, P ＜ 0. 01 ). The patients treated with high-dose dexamethasone or prednisone therapy had no significant differences in sex, age or blood platelet count before treatment.Moreover, the short or long term response rates and the CR rates between the two therapies had no statistically significant differences while the former had a shorter onset time ( F = 10. 34, P ＜ 0. 01 ).Conclusions The study sets up a basis for the application of the recommended new definition and outcome criteria for adult ITP. Dexamethasone therapy is favored as first-line therapy.