Predictive value of response to steroid therapy on response to splenectomy in children with immune thrombocytopenic purpura

Lindsay L. Hollander, Charles M. Leys, Brent R. Weil, Frederick Rescorla

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Many but not all studies suggest that a favorable response to preoperative steroid therapy predicts a successful outcome after splenectomy in children with immune thrombocytopenic purpura (ITP). The purpose of this study is to further examine the relationship between steroid response and outcome after splenectomy in children. Methods: After institutional review board approval, records of children undergoing splenectomy for ITP were reviewed. Patients' responses were determined by platelet counts and grouped by complete response (CR; ≥150,000/μL), partial response (PR; 149,999- ≥50,000/μL), or no response (NR; <50,000/μL). Results: Thirty-seven children were identified. After steroid therapy, 20 patients (54%) had CR, 9 (24%) had PR, and 8 (22%) had NR. After splenectomy, 31 patients (84%) had CR, 6 (16%) had PR, and 0 had NR. Of the 20 patients that had a CR to steroid therapy, 18 (80%) had CR and 2 (20%) had PR to splenectomy. Of the 9 patients that had PR to steroids, 7 (78%) had CR to splenectomy and 2 (22%) had PR. Of the 8 patients that had NR to steroids, 6 (75%) had CR and 2 (25%) had PR to splenectomy. Response to splenectomy was not associated with response to steroids (P =.59). Conclusion: These data suggest that response to splenectomy in children with ITP is unrelated to previous response to steroids.

Original languageEnglish
Pages (from-to)643-648
Number of pages6
JournalSurgery
Volume150
Issue number4
DOIs
StatePublished - Oct 2011

Fingerprint

Idiopathic Thrombocytopenic Purpura
Splenectomy
Steroids
Therapeutics
Research Ethics Committees
Platelet Count

ASJC Scopus subject areas

  • Surgery

Cite this

Predictive value of response to steroid therapy on response to splenectomy in children with immune thrombocytopenic purpura. / Hollander, Lindsay L.; Leys, Charles M.; Weil, Brent R.; Rescorla, Frederick.

In: Surgery, Vol. 150, No. 4, 10.2011, p. 643-648.

Research output: Contribution to journalArticle

Hollander, Lindsay L. ; Leys, Charles M. ; Weil, Brent R. ; Rescorla, Frederick. / Predictive value of response to steroid therapy on response to splenectomy in children with immune thrombocytopenic purpura. In: Surgery. 2011 ; Vol. 150, No. 4. pp. 643-648.
@article{3bafea622bcb42b7aab8ef617a6557c6,
title = "Predictive value of response to steroid therapy on response to splenectomy in children with immune thrombocytopenic purpura",
abstract = "Background: Many but not all studies suggest that a favorable response to preoperative steroid therapy predicts a successful outcome after splenectomy in children with immune thrombocytopenic purpura (ITP). The purpose of this study is to further examine the relationship between steroid response and outcome after splenectomy in children. Methods: After institutional review board approval, records of children undergoing splenectomy for ITP were reviewed. Patients' responses were determined by platelet counts and grouped by complete response (CR; ≥150,000/μL), partial response (PR; 149,999- ≥50,000/μL), or no response (NR; <50,000/μL). Results: Thirty-seven children were identified. After steroid therapy, 20 patients (54{\%}) had CR, 9 (24{\%}) had PR, and 8 (22{\%}) had NR. After splenectomy, 31 patients (84{\%}) had CR, 6 (16{\%}) had PR, and 0 had NR. Of the 20 patients that had a CR to steroid therapy, 18 (80{\%}) had CR and 2 (20{\%}) had PR to splenectomy. Of the 9 patients that had PR to steroids, 7 (78{\%}) had CR to splenectomy and 2 (22{\%}) had PR. Of the 8 patients that had NR to steroids, 6 (75{\%}) had CR and 2 (25{\%}) had PR to splenectomy. Response to splenectomy was not associated with response to steroids (P =.59). Conclusion: These data suggest that response to splenectomy in children with ITP is unrelated to previous response to steroids.",
author = "Hollander, {Lindsay L.} and Leys, {Charles M.} and Weil, {Brent R.} and Frederick Rescorla",
year = "2011",
month = "10",
doi = "10.1016/j.surg.2011.07.063",
language = "English",
volume = "150",
pages = "643--648",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Predictive value of response to steroid therapy on response to splenectomy in children with immune thrombocytopenic purpura

AU - Hollander, Lindsay L.

AU - Leys, Charles M.

AU - Weil, Brent R.

AU - Rescorla, Frederick

PY - 2011/10

Y1 - 2011/10

N2 - Background: Many but not all studies suggest that a favorable response to preoperative steroid therapy predicts a successful outcome after splenectomy in children with immune thrombocytopenic purpura (ITP). The purpose of this study is to further examine the relationship between steroid response and outcome after splenectomy in children. Methods: After institutional review board approval, records of children undergoing splenectomy for ITP were reviewed. Patients' responses were determined by platelet counts and grouped by complete response (CR; ≥150,000/μL), partial response (PR; 149,999- ≥50,000/μL), or no response (NR; <50,000/μL). Results: Thirty-seven children were identified. After steroid therapy, 20 patients (54%) had CR, 9 (24%) had PR, and 8 (22%) had NR. After splenectomy, 31 patients (84%) had CR, 6 (16%) had PR, and 0 had NR. Of the 20 patients that had a CR to steroid therapy, 18 (80%) had CR and 2 (20%) had PR to splenectomy. Of the 9 patients that had PR to steroids, 7 (78%) had CR to splenectomy and 2 (22%) had PR. Of the 8 patients that had NR to steroids, 6 (75%) had CR and 2 (25%) had PR to splenectomy. Response to splenectomy was not associated with response to steroids (P =.59). Conclusion: These data suggest that response to splenectomy in children with ITP is unrelated to previous response to steroids.

AB - Background: Many but not all studies suggest that a favorable response to preoperative steroid therapy predicts a successful outcome after splenectomy in children with immune thrombocytopenic purpura (ITP). The purpose of this study is to further examine the relationship between steroid response and outcome after splenectomy in children. Methods: After institutional review board approval, records of children undergoing splenectomy for ITP were reviewed. Patients' responses were determined by platelet counts and grouped by complete response (CR; ≥150,000/μL), partial response (PR; 149,999- ≥50,000/μL), or no response (NR; <50,000/μL). Results: Thirty-seven children were identified. After steroid therapy, 20 patients (54%) had CR, 9 (24%) had PR, and 8 (22%) had NR. After splenectomy, 31 patients (84%) had CR, 6 (16%) had PR, and 0 had NR. Of the 20 patients that had a CR to steroid therapy, 18 (80%) had CR and 2 (20%) had PR to splenectomy. Of the 9 patients that had PR to steroids, 7 (78%) had CR to splenectomy and 2 (22%) had PR. Of the 8 patients that had NR to steroids, 6 (75%) had CR and 2 (25%) had PR to splenectomy. Response to splenectomy was not associated with response to steroids (P =.59). Conclusion: These data suggest that response to splenectomy in children with ITP is unrelated to previous response to steroids.

UR - http://www.scopus.com/inward/record.url?scp=80054123288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054123288&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2011.07.063

DO - 10.1016/j.surg.2011.07.063

M3 - Article

VL - 150

SP - 643

EP - 648

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 4

ER -