Idiopathic thrombocytopenic purpura -: A retrospective analysis in 139 patients of the influence of age on the response to corticosteroids, splenectomy and danazol

被引:25
作者
Andrès, E
Zimmer, J
Noel, E
Kaltenbach, G
Koumarianou, A
Maloisel, F
机构
[1] Hop Univ Strasbourg, Hop Civil, Clin Med B, Serv Med Interne, F-67091 Strasbourg, France
[2] Hop Univ Strasbourg, Dept Oncohematol, F-67091 Strasbourg, France
[3] Ludwig Inst Canc Res, Lausanne Branch, CH-1066 Epalinges, Switzerland
[4] Hop Univ Strasbourg, Dept Internal Med & Geriatr, F-67091 Strasbourg, France
关键词
D O I
10.2165/00002512-200320110-00005
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To review the influence of age on the response of patients with idiopathic thrombocytopenic purpura (ITP) to corticosteroids, splenectomy and danazol. Methods: We retrospectively reviewed a cohort of 139 consecutively treated patients with ITP diagnosed between 1985 and 1994. In particular, we analysed the therapies used, their response rates, prognostic indicators of response and adverse effects. Furthermore, we compared the efficacy and tolerability of the various therapies between younger and older patients (<60 and greater than or equal to60 years old). Results: Corticosteroids were used as first-line treatment in 118 patients with an initial response rate of 83%. Age did not affect the outcome of corticosteroid therapy, but all the patients aged greater than or equal to60 years reported adverse effects. A splenectomy was performed in 55 patients with an initial response rate of 87%. Older patients had significantly poorer outcomes from splenectomy with higher postoperative morbidity. Finally, danazol was given in 33 patients with a favourable response in 72% of cases. Compared with younger patients, older patients had a significantly better outcome with danazol. Conclusions: Age may have significant effects on the response to and adverse effects of therapy in ITP, and this should be considered when choosing the treatment modality for the elderly.
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页码:841 / 846
页数:6
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