Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy
Immunologic thrombocytopenic purpura (ITP) is a condition that affects four to 18 per 100 000 children every year. In most cases, spontaneous remission occurs, but splenectomy may be proposed. Exploring the site of platelet sequestration can help to better predict potential poor responders to splene...
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| Format: | Article |
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SAGE Publishing
2024-11-01
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| Series: | Molecular Imaging |
| Online Access: | https://doi.org/10.1177/15353508241293961 |
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| author | Julien Dubois PharmD Florentin Kucharczak PhD Léa De Neef PharmD Virginie Kouyoumdjian PharmD Gilles Palenzuela MD Virginie Tunez MD Denis Mariano-Goulart MD, PhD Aurélie Bourdon MD Tom Paunet MD |
| author_facet | Julien Dubois PharmD Florentin Kucharczak PhD Léa De Neef PharmD Virginie Kouyoumdjian PharmD Gilles Palenzuela MD Virginie Tunez MD Denis Mariano-Goulart MD, PhD Aurélie Bourdon MD Tom Paunet MD |
| author_sort | Julien Dubois PharmD |
| collection | DOAJ |
| description | Immunologic thrombocytopenic purpura (ITP) is a condition that affects four to 18 per 100 000 children every year. In most cases, spontaneous remission occurs, but splenectomy may be proposed. Exploring the site of platelet sequestration can help to better predict potential poor responders to splenectomy, but 111 In-radiolabeled platelet scintigraphy (IPS) can be difficult to perform in children with very few platelets. A 12-year-old boy suffering from refractory ITP was referred for evaluation of platelet survival and sequestration and consideration of splenectomy. His platelet count consistently remained below 10 000/mm 3 . An exceptional procedure was set up to use homologous platelets to perform the IPS. Splenectomy was ruled out based on the results of 111 In-radiolabeled homologous platelet scintigraphy. The attending pediatrician intensified medical treatments, resulting in a significant improvement in platelet count. This increase in platelet levels allowed for 111 In-radiolabeled autologous platelet scintigraphy, which confirmed the absence of splenic sequestration. This allowed us to reject splenectomy in this child. Homologous IPS could help clinicians to choose splenectomy as a treatment option for ITP in children with a very low platelet count, and its use should be promoted after failed thrombopoietin receptor agonist (TPO-RA) treatment. More systematic studies are needed to confirm the predictive response to splenectomy of homologous IPS. |
| format | Article |
| id | doaj-art-cbd94be3172c4a4c8acee6075f03185d |
| institution | Kabale University |
| issn | 1536-0121 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Molecular Imaging |
| spelling | doaj-art-cbd94be3172c4a4c8acee6075f03185d2025-02-03T06:54:54ZengSAGE PublishingMolecular Imaging1536-01212024-11-012310.1177/15353508241293961Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary SplenectomyJulien Dubois PharmD0Florentin Kucharczak PhD1Léa De Neef PharmD2Virginie Kouyoumdjian PharmD3Gilles Palenzuela MD4Virginie Tunez MD5Denis Mariano-Goulart MD, PhD6Aurélie Bourdon MD7Tom Paunet MD8 Cancer Research Institute of Montpellier (IRCM), INSERM U1194, , Montpellier, France Nuclear Medicine Department, , Montpellier, France Radiopharmacy Department, , Montpellier, France Radiopharmacy Department, , Montpellier, France Pediatric Hematology-Oncology Department, , Montpellier, France Haemovigilance Department, , Montpellier, France PhyMedExp, INSERM U1046, CNRS UMR 9214, , Montpellier, France Nuclear Medicine Department, , Montpellier, France Nuclear Medicine Department, , Montpellier, FranceImmunologic thrombocytopenic purpura (ITP) is a condition that affects four to 18 per 100 000 children every year. In most cases, spontaneous remission occurs, but splenectomy may be proposed. Exploring the site of platelet sequestration can help to better predict potential poor responders to splenectomy, but 111 In-radiolabeled platelet scintigraphy (IPS) can be difficult to perform in children with very few platelets. A 12-year-old boy suffering from refractory ITP was referred for evaluation of platelet survival and sequestration and consideration of splenectomy. His platelet count consistently remained below 10 000/mm 3 . An exceptional procedure was set up to use homologous platelets to perform the IPS. Splenectomy was ruled out based on the results of 111 In-radiolabeled homologous platelet scintigraphy. The attending pediatrician intensified medical treatments, resulting in a significant improvement in platelet count. This increase in platelet levels allowed for 111 In-radiolabeled autologous platelet scintigraphy, which confirmed the absence of splenic sequestration. This allowed us to reject splenectomy in this child. Homologous IPS could help clinicians to choose splenectomy as a treatment option for ITP in children with a very low platelet count, and its use should be promoted after failed thrombopoietin receptor agonist (TPO-RA) treatment. More systematic studies are needed to confirm the predictive response to splenectomy of homologous IPS.https://doi.org/10.1177/15353508241293961 |
| spellingShingle | Julien Dubois PharmD Florentin Kucharczak PhD Léa De Neef PharmD Virginie Kouyoumdjian PharmD Gilles Palenzuela MD Virginie Tunez MD Denis Mariano-Goulart MD, PhD Aurélie Bourdon MD Tom Paunet MD Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy Molecular Imaging |
| title | Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy |
| title_full | Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy |
| title_fullStr | Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy |
| title_full_unstemmed | Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy |
| title_short | Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy |
| title_sort | homologous in radiolabeled platelet survival and sequestration exploration for refractory immunologic thrombocytopenic purpura in children a strategy to avoid unnecessary splenectomy |
| url | https://doi.org/10.1177/15353508241293961 |
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