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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorLozano, Maria L.
dc.contributor.authorMingot-Castellano, M.E.
dc.contributor.authorPerera, María M.
dc.contributor.authorJarque, Isidro
dc.contributor.authorCampos-Alvarez, Rosa M.
dc.contributor.authorGonzález-López, Tomás José
dc.contributor.authorValcarcel Ferreiras, David
dc.date.accessioned2021-07-09T06:47:17Z
dc.date.available2021-07-09T06:47:17Z
dc.date.issued2021-02
dc.identifier.citationLozano ML, Mingot-Castellano ME, Perera MM, Jarque I, Campos-Alvarez RM, González-López TJ, et al. A decade of changes in management of immune thrombocytopenia, with special focus on elderly patients. Blood Cells, Mol Dis. 2021 Feb;86:102505.
dc.identifier.issn1096-0961
dc.identifier.urihttp://hdl.handle.net/11351/6139
dc.descriptionElderly; Guidelines; TPO-RA
dc.description.abstractBackground Ten years after their availability, thrombopoietin receptor agonists (TPO-RA) have heralded a paradigm shift in the treatment of immune thrombocytopenia (ITP). This study was aimed to analyze the implementation of current recommendations in the standard practice of adult ITP patients, and how age may influence those changes. Methods We included 121 adult patients (> 65 years, n = 54; younger individuals, n = 67) who initiated treatment with TPO-RA between January 2012 and December 2014. Results Patients older than 65 years treated with TPO-RA presented at diagnosis with significantly higher platelet counts, less bleeding, and a more prothrombotic profile than younger ones. The high efficacy rates of TPO-RA, preferentially used during the last decade in non-chronic phases, precluded from further therapies in the majority of ITP patients. Their administration was associated with a sharp decline in the last decade in the use of splenectomy and intravenous immunoglobulin, especially in younger ITP individuals. Conclusion These results confirm (1) that there is a preferential use of TPO-RAs in elderly ITP patients with fewer bleeding complications but more unfavorable prothrombotic conditions than in younger individuals, and (2) that early use of these agents has been established as an effective therapeutic alternative to other second line therapies.
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofseriesBlood Cells, Molecules, and Diseases;86
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceScientia
dc.subjectCitocines - Receptors
dc.subjectPersones grans
dc.subjectTrombocitopènia - Tractament
dc.subject.meshReceptors, Thrombopoietin
dc.subject.mesh/agonists
dc.subject.meshPurpura, Thrombocytopenic, Idiopathic
dc.subject.meshAged
dc.titleA decade of changes in management of immune thrombocytopenia, with special focus on elderly patients
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1016/j.bcmd.2020.102505
dc.subject.decsreceptores de trombopoyetina
dc.subject.decs/agonistas
dc.subject.decspúrpura trombocitopénica idiopática
dc.subject.decsanciano
dc.relation.publishversionhttps://www.sciencedirect.com/science/article/pii/S1079979620304563?via%3Dihub
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Lozano ML] Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain. [Mingot-Castellano ME] Hospital Carlos Haya, Málaga, Hospital Universitario Virgen del Rocio, Sevilla, Spain. [Perera MM] Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain. [Jarque I] Hospital Universitario y Politécnico La Fe, Valencia, Spain. [Campos-Alvarez RM] Hospital de Especialidades de Jerez de la Frontera, Cádiz, Spain. [González-López TJ] Hospital Universitario de Burgos, Burgos, Spain. [Valcarcel D] Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain
dc.identifier.pmid32979651
dc.identifier.wos000603537900009
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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