Blood:ITP患儿确诊时予以IVIg预治疗可提高早期缓解率,但不影响慢性ITP发生率

2018-07-02 MedSci MedSci原创

中心点:对于新确诊的ITP患儿,确诊时予以IVIg治疗并不能降低慢性ITP的发生率。用IVIg进行预治疗有助于快速恢复、减少重度出血事件。摘要:对于新确诊的免疫性血小板减少症(ITP)患儿可予以密切观察或免疫调节治疗。观察性研究提示静脉输注免疫球蛋白(IVIg)治疗可降低患儿慢性ITP的发生率。Katja M.J. Heitink-Pollé等人开展一多中心的随机试验,招募3个月-16岁的新确诊的

中心点:

对于新确诊的ITP患儿,确诊时予以IVIg治疗并不能降低慢性ITP的发生率。

用IVIg进行预治疗有助于快速恢复、减少重度出血事件。

摘要:

对于新确诊的免疫性血小板减少症(ITP)患儿可予以密切观察或免疫调节治疗。观察性研究提示静脉输注免疫球蛋白(IVIg)治疗可降低患儿慢性ITP的发生率。

Katja M.J. Heitink-Pollé等人开展一多中心的随机试验,招募3个月-16岁的新确诊的、血小板计数≤20x109/L并有轻到中度出血的ITP患儿,将其随机分组,接受单次0.8g/kg IVIg治疗或密切观察。主要结点是进展成慢性ITP(研究起始时定义为6个月后血小板计数<150x109/L)。

共招募了206位患儿,其中102位接受IVIg治疗,104位接受密切观察。IVIg组和观察组分别有18.6%和28.9%的患儿进展成慢性ITP(相对风险[RR]0.64;95% CI 0.38-1.08)。12个月时,IVIg组和观察组分别有10%和12%的患儿血小板计数<100x109/L(目前慢性ITP的定义)(RR 0.83;95% CI 0.38-1.84)。前3个月时,IVIg组的完全缓解率明显高于观察组。IgG-Fc受体IIb遗传突变与两组早期完全缓解均相关。观察组有9%的患儿发生4-5级出血事件,而IVIg组仅1%。

总而言之,ITP患儿确诊时,予以IVIg治疗虽然不能降低慢性ITP的发生率,但可提高患儿早期缓解率,并减少出血事件。

原始出处:

Katja M.J. Heitink-Pollé,et al. Intravenous immunoglobulin versus observation in childhood immune thrombocytopenia: a randomized controlled trial. Blood  2018  :blood-2018-02-830844;  doi: https://doi.org/10.1182/blood-2018-02-830844

本文系梅斯医学(MedSci)原创编译,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1826461, encodeId=e27518264610d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Jul 16 05:09:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418426, encodeId=3281141842670, content=<a href='/topic/show?id=c8f210115bc' target=_blank style='color:#2F92EE;'>#ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10115, encryptionId=c8f210115bc, topicName=ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2523357226, createdName=whmdzju, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574067, encodeId=7bcf15e406739, content=<a href='/topic/show?id=15d153444a7' target=_blank style='color:#2F92EE;'>#慢性ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53444, encryptionId=15d153444a7, topicName=慢性ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=573a15990581, createdName=limedical1979, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603192, encodeId=66dc160319211, content=<a href='/topic/show?id=dae71013e1a' target=_blank style='color:#2F92EE;'>#IVIG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10137, encryptionId=dae71013e1a, topicName=IVIG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e10e18994988, createdName=xre2014, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328709, encodeId=1a5c328e097f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 02 11:45:15 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1826461, encodeId=e27518264610d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Jul 16 05:09:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418426, encodeId=3281141842670, content=<a href='/topic/show?id=c8f210115bc' target=_blank style='color:#2F92EE;'>#ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10115, encryptionId=c8f210115bc, topicName=ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2523357226, createdName=whmdzju, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574067, encodeId=7bcf15e406739, content=<a href='/topic/show?id=15d153444a7' target=_blank style='color:#2F92EE;'>#慢性ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53444, encryptionId=15d153444a7, topicName=慢性ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=573a15990581, createdName=limedical1979, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603192, encodeId=66dc160319211, content=<a href='/topic/show?id=dae71013e1a' target=_blank style='color:#2F92EE;'>#IVIG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10137, encryptionId=dae71013e1a, topicName=IVIG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e10e18994988, createdName=xre2014, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328709, encodeId=1a5c328e097f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 02 11:45:15 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2018-07-04 whmdzju
  3. [GetPortalCommentsPageByObjectIdResponse(id=1826461, encodeId=e27518264610d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Jul 16 05:09:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418426, encodeId=3281141842670, content=<a href='/topic/show?id=c8f210115bc' target=_blank style='color:#2F92EE;'>#ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10115, encryptionId=c8f210115bc, topicName=ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2523357226, createdName=whmdzju, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574067, encodeId=7bcf15e406739, content=<a href='/topic/show?id=15d153444a7' target=_blank style='color:#2F92EE;'>#慢性ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53444, encryptionId=15d153444a7, topicName=慢性ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=573a15990581, createdName=limedical1979, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603192, encodeId=66dc160319211, content=<a href='/topic/show?id=dae71013e1a' target=_blank style='color:#2F92EE;'>#IVIG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10137, encryptionId=dae71013e1a, topicName=IVIG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e10e18994988, createdName=xre2014, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328709, encodeId=1a5c328e097f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 02 11:45:15 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1826461, encodeId=e27518264610d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Jul 16 05:09:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418426, encodeId=3281141842670, content=<a href='/topic/show?id=c8f210115bc' target=_blank style='color:#2F92EE;'>#ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10115, encryptionId=c8f210115bc, topicName=ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2523357226, createdName=whmdzju, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574067, encodeId=7bcf15e406739, content=<a href='/topic/show?id=15d153444a7' target=_blank style='color:#2F92EE;'>#慢性ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53444, encryptionId=15d153444a7, topicName=慢性ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=573a15990581, createdName=limedical1979, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603192, encodeId=66dc160319211, content=<a href='/topic/show?id=dae71013e1a' target=_blank style='color:#2F92EE;'>#IVIG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10137, encryptionId=dae71013e1a, topicName=IVIG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e10e18994988, createdName=xre2014, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328709, encodeId=1a5c328e097f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 02 11:45:15 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2018-07-04 xre2014
  5. [GetPortalCommentsPageByObjectIdResponse(id=1826461, encodeId=e27518264610d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Jul 16 05:09:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418426, encodeId=3281141842670, content=<a href='/topic/show?id=c8f210115bc' target=_blank style='color:#2F92EE;'>#ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10115, encryptionId=c8f210115bc, topicName=ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2523357226, createdName=whmdzju, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574067, encodeId=7bcf15e406739, content=<a href='/topic/show?id=15d153444a7' target=_blank style='color:#2F92EE;'>#慢性ITP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53444, encryptionId=15d153444a7, topicName=慢性ITP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=573a15990581, createdName=limedical1979, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603192, encodeId=66dc160319211, content=<a href='/topic/show?id=dae71013e1a' target=_blank style='color:#2F92EE;'>#IVIG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10137, encryptionId=dae71013e1a, topicName=IVIG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e10e18994988, createdName=xre2014, createdTime=Wed Jul 04 01:09:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328709, encodeId=1a5c328e097f, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Jul 02 11:45:15 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2018-07-02 天地飞扬

    了解一下.谢谢分享!

    0

相关资讯

Lancet子刊:高剂量地塞米松对于免疫性血小板减少症效果并不理想

高剂量地塞米松对于未经治疗过的免疫性血小板减少症患者的长期疗效和安全性尚不清楚。研究人员做了一项随机试验的系统回顾和荟萃分析,旨在确定与泼尼松相比,高剂量地塞米松对于血小板计数的长期效果。研究人员检索了MEDLINE,Embase,护理及相关健康文献累计索引(CINAHL),和Cochrane图书馆数据库在1970年至2016年七月发表的研究,并检索了从2004年到2015年美国血液协会年度会议发

Lancet:romiplostim对儿童免疫性血小板减少症(ITP)显著疗效

美国生物技术巨头安进(Amgen)近日宣布,在有症状免疫性血小板减少症(ITP)儿科群体中开展的有关升血小板药物Nplate(romiplostim)的一项随机双盲安慰剂对照III期研究的积极数据已发表于国际顶级期刊《柳叶刀》(The Lancet)。儿科ITP患者因血小板计数低,存在严重出血事件风险,这对于儿科患者自身及其父母而言,都是非常可怕的。而该项研究表明,Nplate能够降低有症状ITP