Mean platelet volume and response to the first line therapy in newly diagnosed adult immune thrombocytopenia patients: a retrospective study

Background/aim: Immune thrombocytopenia ITP is treated by corticosteroids and/or intravenous immune globulin as the first line treatment when necessary. Mean platelet volume MPV is a marker of platelet production and function. In this study, we aimed to search the relationship between the MPV and the treatment response in ITP patients and it was hypothesized that MPV can be used as a predictor of the response. Materials and methods: The 70 newly diagnosed adult primary ITP patients and 70 of healthy people were included. MPV between ITP and healthy population, MPV in the diagnosis and after the treatment between the responders and the nonresponders were compared. Results: The responders had significantly higher MPV and the nonresponders had significantly lower MPV than the healthy population 11.09 and 10.21 fL, P = 0.03; 9.38 and 10.21 fL, P = 0.001 . MPV in the diagnosis was significantly higher in the responders than the nonresponders 11.09 and 9.38 fL, P = 0.005 . MPV significantly changed after the treatment in the responders 11.09 to 9.32 fL, P = 0.004 . Conclusion: MPV can be used as a predictor of early response to the first line treatment in newly diagnosed adult primary ITP patients.

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  • 1. Lambert MP, Gernsheimer TB. Clinical updates in adult immune thrombocytopenia. Blood. 2017; 129 (21): 2829-2835. doi: 10.1182/blood-2017-03-754119
  • 2. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagulation & Fibrinolysis. 1996; 7 (2): 157-161.
  • 3. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. British Journal of Haematology. 2005; 128 (5): 698-702. doi: 10.1111/j.1365- 2141.2004.05357.x
  • 4. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematologica. 2008; 119 (3): 173-177. doi: 10.1159/000135658
  • 5. Noris P, Klersy C, Gresele P, Giona F, Giordano P et al. Platelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: a multicentric, real life study. British Journal of Haematology 2013; 162 (1): 112-119. doi: 10.1111/bjh.12349
  • 6. Negash M, Tsegaye A, G/Medhin A. Diagnostic predictive value of platelet indices for discriminating hypo productive versus immune thrombocytopenia purpura in patients attending a tertiary care teaching hospital in Addis Ababa, Ethiopia. BMC Hematology. 2016; 16 (1): 18. doi: 10.1186/s12878-016-0057-5
  • 7. Gulati I, Kumar H, Sheth J, Dey I. Diagnostic implication of mean platelet volume in thrombocytopenia. Medical Journal of Dr DY Patil Vidyapeeth 2017; 10 (4): 370-375. doi: 10.4103/ mjdrdypu.Mjdrdypu_306_16
  • 8. Tang YT, He P, Li YZ, Chen HZ, Chang XL et al. Diagnostic value of platelet indices and bone marrow megakaryocytic parameters in immune thrombocytopenic purpura. Blood Coagulation & Fibrinolysis. 2017; 28 (1): 83-90. doi: 10.1097/ mbc.0000000000000612
  • 9. Korkmaz S, Uslu AU, Aydin B, Dogan O, Sencan M. Pretreatment and post-treatment changes in platelet indices in patients with immune thrombocytopenia. Saudi Medical Journal. 2013; 34 (6): 591-596.
  • 10. Chen C, Song J, Wang Q, Wang LH, Guo PX. Mean platelet volume at baseline and immune thrombocytopenia relapse in Chinese newly-diagnosed patients: a retrospective cohort study. Hematology 2018; 23 (9): 646-652. doi: 10.1080/10245332.2018.1461317
  • 11. Toprak SK, Erismis B, Karakus S, Kursun N, Haberal A et al. Does thrombocyte size give us an idea about thrombocytosis etiology? The Scientific World Journal. 2012; 2012: 5. doi: 10.1100/2012/598653
  • 12. Lee E, Kim M, Jeon K, Lee J, Lee JS et al. Mean Platelet Volume, Platelet Distribution Width, and Platelet Count, in Connection with Immune Thrombocytopenic Purpura and Essential Thrombocytopenia. Laboratory Medicine 2019; 50 (3): 279- 285. doi: 10.1093/labmed/lmy082
  • 13. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982; 143 (1): 29-36. doi: 10.1148/radiology.143.1.7063747
  • 14. Godeau B, Chevret S, Varet B, Lefrere F, Zini JM et al. Intravenous immunoglobulin or high-dose methylprednisolone, with or without oral prednisone, for adults with untreated severe autoimmune thrombocytopenic purpura: a randomised, multicentre trial. The Lancet 2002; 359 (9300): 23-29. doi: 10.1016/s0140-6736(02)07275-6
  • 15. Stasi R, Stipa E, Masi M, Cecconi M, Scimo MT et al. Longterm observation of 208 adults with chronic idiopathic thrombocytopenic purpura. The American Journal of Medicine 1995; 98 (5): 436-442. doi: 10.1016/s0002-9343(99)80342-8
  • 16. Cines DB, Bussel JB, Liebman HA, Luning Prak ET. The ITP syndrome: pathogenic and clinical diversity. Blood 2009; 113 (26): 6511-6521. doi: 10.1182/blood-2009-01-129155
  • 17. Zufferey A, Kapur R, Semple JW. Pathogenesis and Therapeutic Mechanisms in Immune Thrombocytopenia (ITP). Journal of Clinical Medicine 2017; 6 (2): 16. doi: 10.3390/jcm6020016
  • 18. Hansen RJ, Balthasar JP. Mechanisms of IVIG action in immune thrombocytopenic purpura. Clinical Laboratory 2004; 50 (3-4): 133-140.
  • 19. Settipane GA, Pudupakkam RK, McGowan JH. Corticosteroid effect on immunoglobulins. Journal of Allergy and Clinical Immunology 1978; 62 (3): 162-166. doi: 10.1016/0091- 6749(78)90101-x
  • 20. Posey WC, Nelson HS, Branch B, Pearlman DS. The effects of acute corticosteroid therapy for asthma on serum immunoglobulin levels. The Journal of Allergy and Clinical Immunology 1978; 62 (6): 340-348. doi: 10.1016/0091- 6749(78)90134-3
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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