Hindilerden Fehmi, Yonal-Hindilerden Ipek, Yenerel Mustafa Nuri, Nalcaci Meliha, Diz-Kucukkaya Reyhan
Division of Hematology, Department of Internal Medicine, Hamidiye School of Medicine, University of Health Sciences, Istanbul 34730, Turkey.
Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Istanbul 34130, Turkey.
Hematol Rep. 2022 Jul 5;14(3):222-227. doi: 10.3390/hematolrep14030030.
No data exist for the association between the presence of accessory spleen after splenectomy and response to rituximab in immune thrombocytopenia (ITP). We investigated the relationship between accessory spleen presence and rituximab response in splenectomized ITP patients. Fifteen chronic refractory ITP patients were included. Four weekly doses of rituximab 375 mg/m were administered. All patients had undergone splenectomy before rituximab administration. Accessory spleen was detected in 5 of 15 patients (33.3%). Median age at diagnosis was significantly higher in patients with accessory spleen than those without accessory spleen (40 (range 25-68 years) and 26 (range 7-40 years), respectively; = 0.049). There was a trend for older age at time of rituximab initiation in patients with accessory spleen compared to the other group (median 51 (range 43-75 years) and 42.5 (range 30-60 years), respectively; = 0.066). Median follow-up duration was 96 months (range 40-98). We demonstrated a significant correlation between accessory spleen presence and older age. Accessory spleen presence correlated with higher platelet and WBC counts. We showed good inverse correlation between presence of accessory spleen and time to early response (ER) to rituximab while the rate of early response (ER), late response (LR), sustained response (SR) and overall response (OR) did not differ with respect to the presence of acessory spleen.
关于脾切除术后副脾的存在与免疫性血小板减少症（ITP）患者对利妥昔单抗反应之间的关联，目前尚无相关数据。我们调查了脾切除术后ITP患者中副脾的存在与利妥昔单抗反应之间的关系。纳入了15例慢性难治性ITP患者。给予4周剂量的利妥昔单抗，375mg/m²。所有患者在使用利妥昔单抗之前均已接受脾切除术。15例患者中有5例（33.3%）检测到副脾。有副脾的患者诊断时的中位年龄显著高于无副脾的患者（分别为40岁（范围25 - 68岁）和26岁（范围7 - 40岁）；P = 0.049）。与另一组相比，有副脾的患者开始使用利妥昔单抗时的年龄有增大趋势（中位年龄分别为51岁（范围43 - 75岁）和42.5岁（范围30 - 60岁）；P = 0.066）。中位随访时间为96个月（范围40 - 98个月）。我们证明了副脾存在与年龄较大之间存在显著相关性。副脾的存在与较高的血小板和白细胞计数相关。我们发现副脾的存在与利妥昔单抗早期反应（ER）时间呈良好的负相关，而早期反应（ER）、晚期反应（LR）、持续反应（SR）和总体反应（OR）率在有无副脾方面并无差异。
