Response to high-dose intravenous immune globulin as a valuable factor predicting the effect of splenectomy in chronic idiopathic thrombocytopenic purpura patients

This study was conducted to verify whether the response to high-dose intrav enous immune globulin (IVIG) was related to the effect of splenectomy in ch ronic idiopathic thrombocytopenic purpura (ITP) patients. A total of 79 pat ients over 16 years of age were enrolled in this study. The response to the treatment was classified on the basis of the platelet count as no response (NR, <50 x 10(9)/l), incomplete response (IR, (50-150) x 10(9)/l), and com plete response (CR, >150 x 10(9)/l). The response was evaluated after the i nfusion of high-dose IVIG, within 2 weeks after splenectomy (immediate resp onse), and during a follow-up period of more than 6 months after splenectom y (sustained response), respectively. 58 patients (73.4%) showed responses (CR or IR) to high-dose IVIG. After splenectomy, immediate responses were o bserved in 73 patients (92%), The response to high-dose IVIG had no relatio nship with the immediate response to splenectomy (P = 0.333). A follow-up e valuation was possible with 58 patients; 6 patients with NR in immediate re sponses did not show any response during the follow-up period, and 17 patie nts relapsed within 6 months after immediate responses, so 35 patients (60. 3%) had sustained responses. Responders to IVIG had significantly higher su stained response rates to splenectomy than non-responders (62% vs. 38%, P = 0.001), These results indicate that the response to high-dose IVIG could b e a valuable factor predicting the sustained response to splenectomy in chr onic ITP patients. Am. J. Hematol. 66:197-202, 2001, (C) 2001 Wiley-Liss, I nc.