Primer İmmun Trombositopeni Hastalarının Tedavi Öncesi ve Sonrası Hemogram Verilerinin Karşılaştırılması

Abstract

Introduction and purpose: Primary thrombocytopenic purpura (ITP) is one of the most common autoantibody-mediated hemostasis disorders affecting both children and adults. Corticosteroids and IVIG are the first-line treatments for acute ITP. Secondary therapies for ITP include splenectomy, rituximab, thrombopoietin receptor agonists, high-dose corticosteroids and immunosuppressors. The aim of this study is to evaluate the significant changes that can be seen after treatment methods by comparing the pre-treatment and post-treatment hemogram data of ITP patients treated in the last 5 years, and to evaluate the relationship between platelet indices and relapse. Material and Methods: In this study, demographic information, treatment indications, treatment and treatment responses, and preoperative and postoperative hemogram data of 71 patients who were performed by Hacettepe University Faculty of Medicine, Department of Hematology were evaluated retrospectively. Hemogram data of the patients were compared using Wilcoxon rank-sum tests before and after treatment. Results: Of the 71 patients, 26 were male (36.6%) and 45(63.4%) were female. The median age at diagnosis was 34 (18-77) years. 34 (47.8%) patients were found to have steroids. Hemoglobin, hematocrit, MCV, RDW, neutrophil, lymphocyte, leukocyte, platelet and PCT levels were significantly increased (p <0.05). A significant decrease in eosinophil values was observed (p = 0.015). 41 (57.7%) patients with steroid + IVIG were detected. There was a significant increase in RDW, neutrophil, leukocyte, platelet and PCT values (p <0.05). A significant decrease in eosinophil values was found (p = 0.001). 42 patients (59.2%) with splenectomy were detected. There was a significant increase in MCV, RDW, neutrophil, lymphocyte, leukocyte, platelet and PCT values of the patients (p <0.05). Basophil, eosinophil and MPV values were significantly decreased (p <0.05). Six (8.4%) patients with eltrombopag were detected. There was a significant increase in the neutrophil, platelet and PCT values of the patients (p <0.05). The relationship between recurrence of MPV, PDW and PCT was investigated. There was a significant decrease in the first relapse and second relapse PCT (p <0.05). Conclusion: When the hemogram data of the patients were compared before and after the treatment, changes were observed according to the literature. Our study is thought to be the only study comparing hemogram data in patients with ITP. In our study, a significant correlation was found between PCT value and relapse.