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• W3094116900 abstract "espanolAntecedentes: la trombocitopenia inmunitaria secundaria (PTI) es una enfermedad heterogenea e impredecible asociada con diversas afecciones subyacentes. Objetivo: El objetivo del estudio fue investigar la evolucion clinica y los predictores de cronicidad en la PTI secundaria. Metodos: Los pacientes atendidos en un centro medico academico durante el periodo 2008-2019 fueron estratificados por edad en ninos 16 anos. Las respuestas a los esteroides, inmunoglobulina G intravenosa (IVIG), rituximab y eltrombopag se clasificaron como respuesta (R) y respuesta completa (CR). Los factores de riesgo para la PTI cronica se determinaron mediante regresion multiple con analisis univariante y multivariable. Resultados: Se incluyeron 83 pacientes, 37 ninos y 46 adultos. Las condiciones asociadas mas frecuentes fueron infecciones 53%, lupus eritematoso sistemico (LES) 24%, enfermedad tiroidea 9,6% y sindrome de Evans 3,6%. La respuesta al tratamiento de primera linea en toda la cohorte fue del 94%; CR 45,7%; y R 50,6%. La respuesta inicial a los esteroides solos fue del 91,3% (n = 21/23), rituximab mas dexametasona en dosis alta (HDD) del 93,3% (n = 14/15); ninos que reciben IgIV sola 100% (n = 12/12); y eltrombopag en adultos 100% (n = 3/3). Se documento recaida en el 19,4% de los ninos y el 34% de los adultos, con una mediana de tiempo de 15 y 2 meses, respectivamente; El 30,4% de los adultos (el 15,2% del grupo miscelaneo, el 10,9% asociado a LES y el 4,3% asociado a infeccion) y el 18,9% de los ninos siguieron un curso cronico; edad ≥10 anos y plaquetas ≥20 × 109 / L fueron factores de riesgo de PTI cronica en ninos. Conclusion: La evolucion fue heterogenea: se documento una respuesta mejor y mas sostenida en el grupo de infecciones en comparacion con el LES o el grupo miscelaneo. (REV INVEST CLIN. 2021; 73 (1): 31-8) EnglishBackground: Secondary immune thrombocytopenia (ITP) is a heterogeneous and unpredictable disease associated with various underlying conditions. Objective: The objective of the study was to investigate clinical evolution and chronicity predictors in secondary ITP. Methods: Patients treated at an academic medical center during 2008-2019 were stratified by age as children 16 years. Responses to steroids, intravenous immunoglobulin G (IVIG), rituximab, and eltrombopag were classified as response (R) and complete response (CR). Risk factors for chronic ITP were determined by multiple regression with uni- and multi-variate analysis. Results: Eighty-three patients were included, 37 children and 46 adults. The most frequent associated conditions were infections 53%, systemic lupus erythematosus (SLE) 24%, thyroid disease 9.6%, and Evans syndrome 3.6%. Response to first-line treatment in the whole cohort was 94%; CR 45.7%; and R 50.6%. Initial response to steroids alone was 91.3% (n = 21/23), rituximab plus high-dose dexamethasone (HDD) 93.3% (n = 14/15); children receiving IVIG alone 100% (n=12/12); and eltrombopag in adults 100% (n = 3/3). Relapse was documented in 19.4% of children and 34% of adults, at a median time of 15 and 2 months, respectively; 30.4% of adults (15.2% from the miscellaneous group, 10.9% SLE-associated, and 4.3% infection-associated) and 18.9% of children followed a chronic course; age ≥10 years and platelets ≥20 × 109/L were risk factors for chronic ITP in children. Conclusion: Evolution was heterogeneous: a better and more sustained response was documented in the infections group compared to SLE or the miscellaneous group. (REV INVEST CLIN. 2021;73(1):31-8)" @default.
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• W3094116900 date "2021-02-08" @default.
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• W3094116900 title "Diagnoses, Outcomes, and Chronicity Predictors of Patients with Secondary Immune Thrombocytopenia: Ten-Year Data from a Hematology Referral Center" @default.
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• W3094116900 doi "https://doi.org/10.24875/ric.20000214" @default.
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