Department of Blood, Hulunbeir People's Hospital, Hulunbeir, China.
Acta Haematol. 2022;145(5):499-504. doi: 10.1159/000524535. Epub 2022 Apr 11.
This study aimed to detect the association between P-selectin autoantibody positive and response to steroid treatment in newly diagnosed immune thrombocytopenia (ITP) patients.
The data from 105 newly diagnosed adult ITP patients administered with first-line of steroid treatment from October 2016 to May 2021 were retrospectively analyzed. Treatment responses were evaluated within 3 months after the onset of treatment.
Among the 105 patients, 80.00% (84/105) of patients presented with platelet glycoprotein-specific antibody positive; 44.76% (47/105) patients were anti-P-selectin positive, while 35.24% (37/105) were anti-P-selectin negative. No significant difference in overall response was observed between patients who were anti-P-selectin positive and those who were anti-P-selectin negative (74.47% vs. 89.19, χ2 = 2.910, p = 0.088). But patients who were anti-P-selectin negative had significantly higher complete response rate, compared to those who were anti-P-selectin positive (72.97% vs. 48.94%, χ2 = 4,965, p = 0.026). Logistic regression analysis revealed that anti-GP IIb/IIIa positive (OR = 3.114, p = 0.010, 95% CI: 1.313-7.388) and anti-P-selectin positive (OR = 0.309, p = 0.036, 95% CI: 0.127-0.753) were two factors that could affect patients' response.
Our study found that ITP patients with anti-GP IIb/IIIa may have a higher response to steroid treatment, but anti-P-selectin-mediated-ITP might be less responsive to steroid treatment. In adults with ITP, the presence of anti-P-selectin autoantibodies is a predictive factor for poor response to steroid treatment.
本研究旨在检测新诊断的免疫性血小板减少症(ITP)患者中 P 选择素自身抗体阳性与对类固醇治疗反应之间的关系。
回顾性分析了 2016 年 10 月至 2021 年 5 月期间接受一线类固醇治疗的 105 例新诊断的成年 ITP 患者的数据。在治疗开始后 3 个月内评估治疗反应。
在 105 例患者中,80.00%(84/105)的患者血小板糖蛋白特异性抗体阳性;44.76%(47/105)的患者抗 P 选择素阳性,而 35.24%(37/105)的患者抗 P 选择素阴性。抗 P 选择素阳性与抗 P 选择素阴性患者的总体反应无显著差异(74.47%比 89.19%,χ2=2.910,p=0.088)。但抗 P 选择素阴性患者的完全缓解率明显高于抗 P 选择素阳性患者(72.97%比 48.94%,χ2=4,p=0.026)。Logistic 回归分析显示,抗 GP IIb/IIIa 阳性(OR=3.114,p=0.010,95%CI:1.313-7.388)和抗 P 选择素阳性(OR=0.309,p=0.036,95%CI:0.127-0.753)是影响患者反应的两个因素。
本研究发现,ITP 患者抗 GP IIb/IIIa 可能对类固醇治疗有更高的反应,但抗 P 选择素介导的 ITP 可能对类固醇治疗反应不佳。在成人 ITP 中,抗 P 选择素自身抗体的存在是对类固醇治疗反应不良的预测因素。