The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia
Objective: Standard-dose methylprednisolone (methyl-Pd) is generally preferred as the first-line treatment in immune thrombocytopenia (ITP) unless there is an urgent indication to increase the platelet value. A significant proportion of patients (around 40%) does not benefit from this treatment. Thi...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-03-01
|
| Series: | Medeniyet Medical Journal |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-85520 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832581972767014912 |
|---|---|
| author | Emrah KILICASLAN Murat YILDIRIM Selim SAYIN Erdem CEVIK Meltem AYLI Muhammet Kursat KAPTAN |
| author_facet | Emrah KILICASLAN Murat YILDIRIM Selim SAYIN Erdem CEVIK Meltem AYLI Muhammet Kursat KAPTAN |
| author_sort | Emrah KILICASLAN |
| collection | DOAJ |
| description | Objective: Standard-dose methylprednisolone (methyl-Pd) is generally preferred as the first-line treatment in immune thrombocytopenia (ITP) unless there is an urgent indication to increase the platelet value. A significant proportion of patients (around 40%) does not benefit from this treatment. This study investigated whether pretreatment platelet level and other hemogram indices in patients with ITP patients can be used to predict early response to standard-dose methyl-Pd treatment.
Methods: Patients who received first-line standard-dose methyl- Pd therapy with the diagnosis of primary ITP were included. Patients were categorized as complete responder (CR), responder (R), and nonresponder (NR) according to the response status obtained within the first 14 days of treatment. The hemogram indices of the CR, R, and NR groups measured at the start of the treatment were compared retrospectively.
Results: One hundred forty four patients with ITP were included in the study. The number of patients with NR, R, and CR were 47 (33%), 40 (28%), and 57 (39%), respectively. The mean platelet level of the NR group was lower than responders (R and CR groups) (p=0.002 and p=0.049, respectively). The mean platelet volume (MPV) levels of the NR group were statistically lower than that of the CR group (p=0.018). If MPV ≥10 fL and platelet >12,000/mm³, the probability of an early response with methyl-Pd is higher [sensitivity =98.1% (95% confidence interval (CI) =89.7-99.9%), specificity =45% (95% CI =23.1-68.5%), positive predictive value =82.3% (95% CI =75.7-87.4%), negative predictive value =90% (95% CI =54.9-98.5%)].
Conclusions: Patients with ITP with low platelet and MPV levels were less responsive to standard-dose methyl-Pd treatment. It may be more appropriate to apply more effective treatments to these patients other than standard-dose methyl-Pd alone. |
| format | Article |
| id | doaj-art-969118cec22f4bd7a87ca82a49539ac5 |
| institution | Kabale University |
| issn | 2149-2042 2149-4606 |
| language | English |
| publishDate | 2023-03-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Medeniyet Medical Journal |
| spelling | doaj-art-969118cec22f4bd7a87ca82a49539ac52025-01-30T07:05:47ZengGalenos Publishing HouseMedeniyet Medical Journal2149-20422149-46062023-03-01381636910.4274/MMJ.galenos.2023.85520MEDJ-85520The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune ThrombocytopeniaEmrah KILICASLAN0Murat YILDIRIM1Selim SAYIN2Erdem CEVIK3Meltem AYLI4Muhammet Kursat KAPTAN5University of Health Sciences Turkey, Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital, Clinic of Internal Medicine, Department of Hematology, Istanbul, TurkeyUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, TurkeyUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, TurkeyUniversity of Health Sciences Turkey, Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital, Clinic of Emergency Medicine, Istanbul, TurkeyUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, TurkeyUniversity of Health Sciences Turkey, Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital, Clinic of Internal Medicine, Department of Hematology, Istanbul, TurkeyObjective: Standard-dose methylprednisolone (methyl-Pd) is generally preferred as the first-line treatment in immune thrombocytopenia (ITP) unless there is an urgent indication to increase the platelet value. A significant proportion of patients (around 40%) does not benefit from this treatment. This study investigated whether pretreatment platelet level and other hemogram indices in patients with ITP patients can be used to predict early response to standard-dose methyl-Pd treatment. Methods: Patients who received first-line standard-dose methyl- Pd therapy with the diagnosis of primary ITP were included. Patients were categorized as complete responder (CR), responder (R), and nonresponder (NR) according to the response status obtained within the first 14 days of treatment. The hemogram indices of the CR, R, and NR groups measured at the start of the treatment were compared retrospectively. Results: One hundred forty four patients with ITP were included in the study. The number of patients with NR, R, and CR were 47 (33%), 40 (28%), and 57 (39%), respectively. The mean platelet level of the NR group was lower than responders (R and CR groups) (p=0.002 and p=0.049, respectively). The mean platelet volume (MPV) levels of the NR group were statistically lower than that of the CR group (p=0.018). If MPV ≥10 fL and platelet >12,000/mm³, the probability of an early response with methyl-Pd is higher [sensitivity =98.1% (95% confidence interval (CI) =89.7-99.9%), specificity =45% (95% CI =23.1-68.5%), positive predictive value =82.3% (95% CI =75.7-87.4%), negative predictive value =90% (95% CI =54.9-98.5%)]. Conclusions: Patients with ITP with low platelet and MPV levels were less responsive to standard-dose methyl-Pd treatment. It may be more appropriate to apply more effective treatments to these patients other than standard-dose methyl-Pd alone.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-85520immune thrombocytopeniamethylprednisolonetreatmentcomplete blood count indices |
| spellingShingle | Emrah KILICASLAN Murat YILDIRIM Selim SAYIN Erdem CEVIK Meltem AYLI Muhammet Kursat KAPTAN The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia Medeniyet Medical Journal immune thrombocytopenia methylprednisolone treatment complete blood count indices |
| title | The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia |
| title_full | The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia |
| title_fullStr | The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia |
| title_full_unstemmed | The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia |
| title_short | The Effect of Platelet and Mean Platelet Volume Levels on Standard-dose Methylprednisolone Treatment Response in Primary Immune Thrombocytopenia |
| title_sort | effect of platelet and mean platelet volume levels on standard dose methylprednisolone treatment response in primary immune thrombocytopenia |
| topic | immune thrombocytopenia methylprednisolone treatment complete blood count indices |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-85520 |
| work_keys_str_mv | AT emrahkilicaslan theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT muratyildirim theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT selimsayin theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT erdemcevik theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT meltemayli theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT muhammetkursatkaptan theeffectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT emrahkilicaslan effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT muratyildirim effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT selimsayin effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT erdemcevik effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT meltemayli effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia AT muhammetkursatkaptan effectofplateletandmeanplateletvolumelevelsonstandarddosemethylprednisolonetreatmentresponseinprimaryimmunethrombocytopenia |