<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.4 20241031//EN"
        "https://jats.nlm.nih.gov/publishing/1.4/JATS-journalpublishing1-4.dtd">
<article  article-type="research-article"        dtd-version="1.4">
            <front>

                <journal-meta>
                                    <journal-id></journal-id>
            <journal-title-group>
                                                                                    <journal-title>Dicle Medical Journal</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">1300-2945</issn>
                                        <issn pub-type="epub">1308-9889</issn>
                                                                                            <publisher>
                    <publisher-name>Dicle University</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id pub-id-type="doi">10.5798/dicletip.1906458</article-id>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Health Care Administration</subject>
                                                            <subject>Medical Education</subject>
                                                            <subject>Health Services and Systems (Other)</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Sağlık Kurumları Yönetimi</subject>
                                                            <subject>Tıp Eğitimi</subject>
                                                            <subject>Sağlık Hizmetleri ve Sistemleri (Diğer)</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Efficacy of mycophenolate mofetil treatment in patients with immune thrombocytopenia who have received at least one series of treatment: a single-center study</article-title>
                                                                                                                                                                                                <trans-title-group xml:lang="tr">
                                    <trans-title>En az bir seri tedavi almış immun trombositopeni tanılı hastalarda mikofenolat mofetil tedavisinin etkinliği: tek merkez çalışması</trans-title>
                                </trans-title-group>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                <name>
                                    <surname>Karakuş</surname>
                                    <given-names>Abdullah</given-names>
                                </name>
                                                                    <aff>DICLE UNIVERSITY</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                <name>
                                    <surname>Demircan</surname>
                                    <given-names>Vehbi</given-names>
                                </name>
                                                                    <aff>Dicle University</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                <name>
                                    <surname>Ayyıldız</surname>
                                    <given-names>Orhan</given-names>
                                </name>
                                                                    <aff>Dicle University</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260310">
                    <day>03</day>
                    <month>10</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>53</volume>
                                        <issue>1</issue>
                                        <fpage>103</fpage>
                                        <lpage>107</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20251215">
                        <day>12</day>
                        <month>15</month>
                        <year>2025</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20260213">
                        <day>02</day>
                        <month>13</month>
                        <year>2026</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2003, Dicle Medical Journal</copyright-statement>
                    <copyright-year>2003</copyright-year>
                    <copyright-holder>Dicle Medical Journal</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Background: The objective of this study was to evaluate the efficacy of mycophenolate mofetil (MMF) as a second- or third-line treatment for chronic immune thrombocytopenia (ITP).Methods: A cohort of 13 patients with chronic ITP, who had previously been treated with eltrombopag, corticosteroids, or both, without achieving an effective response, was administered mycophenolate mofetil at a daily dosage of 1000 mg. Platelet counts were monitored at the fourth and twelfth weeks of treatment.Results: In our study, 13 patients were included, consisting of 4 females (30.8%) and 9 males (69.2%). At the 12-week mark following the initiation of MMF therapy, three out of 13 patients achieved a complete response, three out of 13 patients achieved a partial response, and seven patients showed no response. (Fig.1). At the time of transitioning to Mycophenolate Mofetil (MMF), all patients had a platelet count below 30 × 10^9/L. Approximately 40% of patients experienced an increase in platelet counts to levels above 30 × 10^9/L.Conclusions: Mycophenolate mofetil may be considered a potential treatment option for patients with chronic ITP who are refractory to first- and second-line therapies.</p></abstract>
                                                                                                                                    <trans-abstract xml:lang="tr">
                            <p>Amaç: Bu çalışmanın amacı, kronik immün trombositopeni (İTP) tedavisinde ikinci veya üçüncü basamak tedavi olarak mikofenolat mofetilin (MMF) etkinliğini değerlendirmektir.Yöntemler: Daha önce eltrombopag, kortikosteroidler veya her ikisiyle tedavi edilmiş ve etkili bir yanıt alınamamış kronik İTP&#039;li 13 hastadan oluşan bir kohorta, günlük 1000 mg mikofenolat mofetil uygulandı. Trombosit sayıları, tedavinin dördüncü ve on ikinci haftalarında izlendi.Bulgular: Çalışmamıza 4 kadın (%30,8) ve 9 erkek (%69,2) olmak üzere toplam 13 hasta dahil edildi. MMF tedavisinin başlamasından sonraki 12. haftada, 13 hastanın 3&#039;ünde tam yanıt, 13 hastanın 3&#039;ünde yanıt ve 7 hastada yanıt alınamamıştır. Mikofenolat Mofetil&#039;e (MMF) geçiş sırasında tüm hastaların trombosit sayısı 30 × 10^9/L&#039;nin altındaydı. Hastaların yaklaşık %40&#039;ında trombosit sayılarında 30 × 10^9/L&#039;nin üzerine çıkan bir artış görüldü.Sonuç: Mikofenolat mofetil, birinci ve ikinci basamak tedavilere dirençli kronik İTP&#039;li hastalar için potansiyel bir tedavi seçeneği olarak düşünülebilir.</p></trans-abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>Mycophenolate mofetil</kwd>
                                                    <kwd>  Thrombocytopenia</kwd>
                                                    <kwd>  Refractory</kwd>
                                            </kwd-group>
                                                        
                                                                            <kwd-group xml:lang="tr">
                                                    <kwd>Mikofenolat mofetil</kwd>
                                                    <kwd>  Trombositopeni</kwd>
                                                    <kwd>  Dirençli.</kwd>
                                            </kwd-group>
                                                                                                            </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1.Stasi R. How to approach thrombocytopenia.Hematology. 2012(1); 191–7.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2.Terrell DR, Neunert CE, Cooper N, et al. ImmuneThrombocytopenia (ITP): Current Limitations inPatient Management. Medicina. 2020; 56(12):667.</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3. González-López T. J, Newland A, Provan D. CurrentConcepts in the Diagnosis and Management of AdultPrimary Immune Thrombocytopenia: Our PersonalView. Medicina. 2023; 59(4): 815.</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4.Liu X, Hou Y, Hou M. How we treat primaryimmune thrombocytopenia in adults. J. Hematol.Oncol.J Hematol Oncol. 2023; 16 (4): 1-20.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5. Martínez-Carballeira D, Bernardo Á, Caro A, Soto I, Gutiérrez L. Pathophysiology, Clinical Manifestations and Diagnosis of Immune Thrombocytopenia: Contextualization from a Historical Perspective. Hematol Rep. 2024 Apr 3;16(2):204-19.</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6.Al-Samkari H, Kuter, DJ. Immunethrombocytopenia in adults: modern approaches todiagnosis and treatment, Semin. Thromb. Hemost.2020;46(3): 275–88.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7.Cohen YC, Djulbegovic B, Shamai-Lubovitz O,Mozes B. The Bleeding Risk and Natural History ofIdiopathic Thrombocytopenic Purpura in Patientswith Persistent Low Platelet Counts. Arch. Intern.Med. 2000;160(3): 1630–8.</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8.Allison AC, Eugui EM. Purine metabolism andimmunosuppressive effects of mycophenolatemofetil (MMF). Clin. Transplant. 1996; 10: 77–84.</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">9.Hou M, Peng J, Shi Y, et al. Mycophenolate mofetil(MMF) for the treatment of steroid-resistantidiopathic thrombocytopenic purpura. Eur JHaematol. 2003;70(6):353-7.</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">10.K. Kojouri, S.K. Vesely, D.R. Terrell, J.N. GeorgeSplenectomy for adult patients with idiopathicthrombocytopenic purpura: a systematic review toassess long-term platelet count responses,prediction of response, and surgical complicationsBlood, 104 (2004), pp. 2623-34.</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">11.Audia S., Mahevas M., Samson M., Godeau B.,Bonnotte B. Pathogenesis of immunethrombocytopenia. Autoimmun. Rev. 2017; 16:620–32.</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">12.Bradbury CA, Pell J, Hill Q, et al. Mycophenolatemofetil for first-line treatment of immunethrombocytopenia. New England J Med.2021;385(10):885–95.</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">13.Abdelwahab OA, Mechi A, Gahlan S, et al. Efficacyand safety of mycophenolate mofetil in patients withimmune thrombocytopenic purpura: a systematicreview and meta-analysis. Clin. Rheumatol. 2024;43(2): 621–32.</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">14.Zhang W. Ji L, Cao X, Chen Y, et al. Mycophenolatemofetil as a treatment for refractory idiopathicthrombocytopenic purpura. Acta Pharmacol. Sin.2005; 26(5): 598–602.</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">15. Taylor A, Neave L, Solanki S, et al. Mycophenolate mofetil therapy for severe immune thrombocytopenia. Br J Haematol. 2015;171(4):625-30.</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
