INCREASED RETICULAR FIBER GRADE IN PRIMARY IMMUNE THROMBOCYTOPENIA

Year 2023, Volume: 24 Issue: 4, 412 - 418, 09.10.2023

Demircan Özbalcı , Emine Güçhan Alanoğlu , Şirin Başpınar , Enes Günhan , Fatma Gür Hatip , Ahmet Yunus Hatip

https://doi.org/10.18229/kocatepetip.1166629

Abstract

OBJECTIVE: Bone marrow fibrosis in primary immune thrombocytopenia (ITP) has become a centre of attention since cases with fibrosis were reported during trombopoeitin receptor agonist therapies but, there have been few studies evaluating the fibrosis status of the patients at diagnosis. The aim of the study was to evaluate the impact of marrow fibrosis on especially response to treatment and prognosis in patients with ITP.
MATERIAL AND METHODS: Bone marrow reticulin fiber grade, haemoglobin, platelets, age, sex, co-morbidities of the patients, hepatitis and autoimmune markers on admission, response, remission status and duration of remission and treatments were recorded from medical files of the patients and each parameter was evaluated for an association with reticular fiber grade in 53 patients with ITP.
RESULTS: 79.3% of patients had marrow reticulin content grade 1 or more. No significant correlations were found between bone marrow reticular fiber grade and total blood count at diagnosis, response times to the first, second- and third-line treatment, platelet counts after treatment and time between two treatment lines, age, gender, presence of comorbidity and antinuclear antibody positivity and response rate and time. There was a significant and positive correlation between platelet count at diagnosis and age (p<0.05) and, there was a statistically significant and negative correlation between white blood and neutrophil count at diagnosis and age (p<0.05)
CONCLUSIONS: For the first time, higher grade of fibrosis was found in patients with ITP. Prospective studies with follow-up bone marrow biopsies are needed to validate the link between ITP and autoimmune fibrosis.

Keywords

Primary Immune Thrombocytopenia (ITP), Reticular fiber, Prognosis.

Project Number

Yok

PRİMER İMMÜN TROMBOSİTOPENİDE ARTMIŞ RETİKÜLER LİF DERECESİ

Abstract

AMAÇ: Primer immün trombositopenide (İTP) kemik iliği fibrozu, trombopoeitin reseptör agonist tedavileri sırasında fibrozisli vakalar bildirildiğinden ilgi odağı haline gelmiştir, ancak hastaların tanı anında fibrozis durumunu değerlendiren az sayıda çalışma vardı. Bu çalışmanın amacı İTP'li hastalarda kemik iliği fibrozisinin özellikle tedaviye yanıt ve prognoza etkisini değerlendirmektir.
GEREÇ VE YÖNTEM: Hastaların kemik iliği retikülin lif derecesi, hemoglobin, trombosit, yaş, cinsiyet, komorbiditeleri, başvuru sırasında hepatit ve otoimmün belirteçleri, yanıt, remisyon durumu ve remisyon süresi ve tedaviler hastaların tıbbi dosyalarından kaydedildi ve her parametre, İTP'li 53 hastada retiküler lif derecesi ile bir ilişki açısından değerlendirildi.
BULGULAR: Hastaların %79,3’ünde kemik iliği retikülin içeriği derece 1 veya daha fazlaydı. Kemik iliği retiküler lif derecesi ile tanı anında toplam kan sayımı, birinci, ikinci ve üçüncü basamak tedaviye yanıt süreleri, tedavi sonrası trombosit sayıları ve iki tedavi hattı arasındaki süre, yaş, cinsiyet, komorbidite varlığı, antinükleer antikor pozitifliği ve yanıt oranı ve süresi arasında anlamlı bir ilişki bulunmadı. Tanı anındaki trombosit sayısı ile yaş arasında anlamlı ve pozitif korelasyon (p<0,05), tanı anındaki beyaz kan ve nötrofil sayısı ile yaş arasında istatistiksel olarak anlamlı ve negatif korelasyon vardı (p<0,05).
SONUÇ: İTP'li hastalarda ilk kez daha yüksek dereceli fibrozis bulundu. ITP ve otoimmün fibrozis arasındaki bağlantıyı doğrulamak için kemik iliği biyopsilerinin takip edildiği prospektif çalışmalara ihtiyaç vardır.

Keywords

Primer immün trombositopenide (İTP), Retiküler lif, Prognoz

Supporting Institution

Yok

Project Number

Yok

Thanks

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