Page 2207 - Hematology_ Basic Principles and Practice ( PDFDrive )

1954 Part XII Hemostasis and Thrombosis

induce platelet activation through release of platelet-derived RANTES 9a. Mithoowani S, Gregory-Miller K, Goy J, et al: High-dose dexa-
(regulated on activation, normal, T-cell expressed and secreted), a methasone compared with prednisone for previously untreated primary
proinflammatory and immunomodulatory chemokine involved in immune thrombocytopenia: a systematic review and meta-analysis.
multiple immunologic processes, including Ig synthesis and regula- Lancet Haematol 3(10):e489–e496, 2016.
tion of Th1/Th2 cytokine homeostasis. In some patients with PTP, 10. Beck CE, Nathan PC, Parkin PC, et al: Corticosteroids versus intravenous
the alloantibodies have been shown to interfere with cell-fibrinogen immune globulin for the treatment of acute immune thrombocytopenic
interaction, thereby increasing the risk of bleeding. purpura in children: a systematic review and meta-analysis of randomized
The stimulation of specific anti–HPA alloantibodies could in turn controlled trials. J Pediatr 147(4):521–527, 2005.
initiate the formation of platelet-reactive autoantibodies. Production 11. Kojouri K, Vesely SK, Terrell DR, et al: Splenectomy for adult patients
of pan-reactive antibodies has been shown to correspond with the with idiopathic thrombocytopenic purpura: a systematic review to assess
period of greatest thrombocytopenia and serologic analyses of PTP long-term platelet count responses, prediction of response, and surgical
cases demonstrated the presence of reactive IgG and IgM antibodies complications. Blood 104(9):2623–2634, 2004.
against GPIIb/IIIa, GPIX, and GPIa/IIa; however, only HPA-specific 12. Arnold DM, Dentali F, Crowther MA, et al: Systematic review: efficacy
29
IgG antibodies persisted. The presence of autoantibodies can help and safety of rituximab for adults with idiopathic thrombocytopenic
to explain the destruction of both donor and recipient platelets. purpura. Ann Intern Med 146(1):25–33, 2007.
13. Chugh S, Lim W, Crowther MA, et al: Rituximab plus standard of care
for treatment of primary immune thrombocytopenia: a systematic review
Management and meta-analysis. Lancet Haematol 2:e75–e81, 2015.
14. Patel VL, Mahevas M, Lee SY, et al: Outcomes 5 years after response to
Treatment of PTP should be initiated even before serologic test results rituximab therapy in children and adults with immune thrombocytope-
for anti–HPA-antigens are available. The primary goal of treatment nia. Blood 119(25):5989–5995, 2012.
is to abbreviate the period of severe thrombocytopenia and minimize 15. Kuter DJ, Bussel JB, Lyons RM, et al: Efficacy of romiplostim in patients
the risk of bleeding. Multiple treatments are often administered with chronic immune thrombocytopenic purpura: a double-blind ran-
simultaneously or in rapid succession because of the desperate nature domised controlled trial. Lancet 371(9610):395–403, 2008.
of the disorder when it is severe. 16. Cheng G, Saleh MN, Marcher C, et al: Eltrombopag for management of
Patients with PTP require admission to hospital for close obser- chronic immune thrombocytopenia (RAISE): a 6-month, randomised,
vation, supportive treatments, and rapid management of bleeding phase 3 study. Lancet 377(9763):393–402, 2011.
symptoms should they occur. Nonessential transfusions should be 17. Arnold DM, Smith JW, Kelton JG: Diagnosis and management of neonatal
discontinued. The mainstay of therapy is high dose IVIg, which is alloimmune thrombocytopenia. Transfus Med Rev 22(4):255–267, 2008.
30
followed by a platelet count increase after 3–4 days. High-dose 18. Warner MN, Moore JC, Warkentin TE, et al: A prospective study of
corticosteroids have also been tried as a means of inhibiting RES protein-specific assays used to investigate idiopathic thrombocytopenic
phagocytosis and reducing IgG synthesis. Patients with bleeding purpura. Br J Haematol 104(3):442–447, 1999.
should be transfused with HPA-compatible platelets. While awaiting 19. Bakchoul T, Bertrand G, Krautwurst A, et al: The implementation of
the results of antigen typing, HPA-1a–negative platelet transfusions surface plasmon resonance technique in monitoring pregnancies with
can be administered to reduce further antibody production. Patients expected fetal and neonatal alloimmune thrombocytopenia. Transfusion
with PTP may be at increased risk of transfusion reactions such as 53(9):2078–2085, 2013.
fever, dyspnea, and allergic reactions. Plasma exchange should be con- 20. Ghevaert C, Rankin A, Huiskes E, et al: Alloantibodies against low-
sidered in patients who do not respond to IVIg and corticosteroids. frequency human platelet antigens do not account for a significant
proportion of cases of fetomaternal alloimmune thrombocytopenia:
evidence from 1054 cases. Transfusion 49(10):2084–2089, 2009.
REFERENCES 21. Mueller-Eckhardt C, Kiefel V, Grubert A, et al: 348 cases of suspected
neonatal alloimmune thrombocytopenia. Lancet 1(8634):363–366, 1989.
1. Bussel JB, Provan D, Shamsi T, et al: Effect of eltrombopag on platelet 22. Kiefel V, Bassler D, Kroll H, et al: Antigen-positive platelet transfusion
counts and bleeding during treatment of chronic idiopathic thrombocy- in neonatal alloimmune thrombocytopenia (NAIT). Blood 107(9):3761–
topenic purpura: a randomised, double-blind, placebo-controlled trial. 3763, 2006.
Lancet 373:641, 2009. 23. Rayment R, Brunskill SJ, Soothill PW, et al: Antenatal interventions for
2. Kuter DJ, Rummel M, Boccia R, et al: Romiplostim or standard fetomaternal alloimmune thrombocytopenia. Cochrane Database Syst Rev
of care in patients with immune thrombocytopenia. N Engl J Med (5):CD004226, 2011.
363(20):1889–1899, 2010. 24. Berkowitz RL, Kolb EA, McFarland JG, et al: Parallel randomized trials
3. Rodeghiero F, Stasi R, Gernsheimer T, et al: Standardization of termi- of risk-based therapy for fetal alloimmune thrombocytopenia. Obstet
nology, definitions and outcome criteria in immune thrombocytopenic Gynecol 107(1):91–96, 2006.
purpura of adults and children: report from an international working 25. Kjeldsen-Kragh J, Killie MK, Tomter G, et al: A screening and inter-
group. Blood 113(11):2386–2393, 2009. vention program aimed to reduce mortality and serious morbidity
4. Neunert C, Lim W, Crowther M, et al: The American Society of associated with severe neonatal alloimmune thrombocytopenia. Blood
Hematology 2011 evidence-based practice guideline for immune 110(3):833–839, 2007.
thrombocytopenia. Blood 117(16):4190–4207, 2011. 26. Williamson LM, Stainsby D, Jones H, et al: The impact of universal
5. Harrington WJ, Minnich V, Hollingsworth JW, et al: Demonstration of leukodepletion of the blood supply on hemovigilance reports of post-
a thrombocytopenic factor in the blood of patients with thrombocyto- transfusion purpura and transfusion-associated graft-versus-host disease.
penic purpura. J Lab Clin Med 38(1):1–10, 1951. Transfusion 47(8):1455–1467, 2007.
6. Burrows RF, Kelton JG: Fetal thrombocytopenia and its relation to 27. Menis M, Forshee RA, Anderson SA, et al: Posttransfusion purpura
maternal thrombocytopenia. N Engl J Med 329(20):1463–1466, 1993. occurrence and potential risk factors among the inpatient US elderly,
7. Neunert C, Noroozi N, Norman G, et al: Severe bleeding events in as recorded in large Medicare databases during 2011 through 2012.
adults and children with primary immune thrombocytopenia: a system- Transfusion 55(2):284–295, 2015.
atic review. J Thromb Haemost 13(3):457–464, 2015. 28. Woelke C, Eichler P, Washington G, et al: Post-transfusion purpura
8. Hicks LK, Bering H, Carson KR, et al: Five hematologic tests and in a patient with HPA-1a and GPIa/IIa antibodies. Transfus Med
treatments to question. Hematology Am Soc Hematol Educ Program 16(1):69–72, 2006.
2014(1):599–603, 2014. 29. Taaning E, Tonnesen F: Pan-reactive platelet antibodies in post-
9. Cheng Y, Wong RS, Soo YO, et al: Initial treatment of immune throm- transfusion purpura. Vox Sang 76(2):120–123, 1999.
bocytopenic purpura with high-dose dexamethasone. N Engl J Med 30. Mueller-Eckhardt C, Kiefel V: High-dose IgG for post-transfusion
349(9):831–836, 2003. purpura-revisited. Blut 57(4):163–167, 1988.