medigraphic.com
ISSN 0016-3813 (Print)

2014, Number 4

<< Back Next >>

Gac Med Mex 2014; 150 (4)

Trombocitopenia inmune primaria (TIP) del adulto en México: características nacionales y su relación con la literatura internacional

Meillón-García LA, García-Chávez J, Gómez-Almaguer D, Gutiérrez-Espíndola GR, Martínez-Murillo C

Language: Spanish
References: 17
Page: 279-288
PDF size: 98.87 Kb.


ABSTRACT

In order to identify the clinical approach of a sample of Mexican hematologists for primary immune thrombocytopenia (ITP) in adults in Mexico, we applied an electronic survey via the internet to identify common practices for the diagnosis and treatment of ITP and draw a comparison between the information from these hematologists with international guidelines or the international literature. The results were analyzed using measures of central tendency. The sample was 21 medical hematologists, predominantly from Mexico City (average age: 51.4 years). A total of 66.7% of the surveyed physicians use international guidelines to make therapeutic decisions, and 43% defined ITP including the numerical concept (‹ 100 x 109/l). We found some differences between requested clinical exams and tests indicated by the guidelines. In first-line treatment (except emergency), 91% of the participants start with prednisone and 24% use dexamethasone. Danazol is used in persistent ITP by most (41%) of the specialists. In second-line treatment, 67% would indicate splenectomy. Some differences were found between clinical practice of the hematologists in Mexico versus guidelines recommendations.


REFERENCES

  1. Rodeghiero F, Stasi R, Gemsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113(11):2386-93.

  2. Keating GM. Romiplostim. A review of its use in Immune Thrombocytopenia. Drugs. 2012;72(3):415-35.

  3. Pizzuto J, Ambriz R. Therapeutic experience in 934 adults with idiopathic thrombocytopenic purpura: multicentric trial of the Cooperative Latin American Group on hemostasis and thrombosis. Blood. 1984;64(6):1179-83.

  4. Semple JW, Provan D, Garvey MB, Freedman J. Recent progress in understanding the pathogenesis of immune thrombocytopenia. Curr Opin Hematol. 2010;17(6):590-5.

  5. Garnock-Jones KP. Eltrombopag. A review of its use in treatment-refractory chronic primary immune thrombocytopenia. Drugs. 2011; 71(10):1335-53.

  6. Gómez-Almaguer D, Tarín-ArzagaL, Moreno-Jaime B, et al. High response rate to low-dose rituximab plus high-dose dexamethasone as frontline therapy in adult patients with primary immune thrombocytopenia. Eur J Haematol. 2013;90(6):494-500.

  7. Provan D, Stasi R, Newland AC, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-86.

  8. Neunert C, Lim W, Cohen A, et al. The American Society of hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190-207.

  9. Sanz MA, Vicente-García V, Fernández A, et al. [Guidelines for diagnosis, treatment and monitoring of primary immune thrombocytopenia]. Med Clin (Barc). 2012;138(6):261.e1-261.e17.

  10. Eysenbach G, Wyatt J. Using the internet for surveys and health research. J Med Internet Res. 2002;4(2):e13.

  11. Stasi R, Sarpatwari A, Segal JB, et al. Effects of the eradication of Helicobacter pylori infection in patients with immune thrombocytopenic purpura. A systematic review. Blood. 2009;113(6):1231-40.

  12. Cines DB, Bussel JB, Liebman HA, LuningPrak ET. The ITP syndrome: pathogenic and clinical diversity. Blood. 2009;113(26):6511-21.

  13. Cines DB, Liebman H, Stasi R. Pathobiology of secondary immune thrombocytopenia. Semin Hematol. 2009;46(1 Suppl 2):S2-14.

  14. Estrada-Gómez RA, Parra-Ortega I, Martínez-Barreda C, Ruiz-Argüelles GJ. Helicobacter pylori infection and thrombocytopenia: a single-institutionexperience in Mexico. Rev Invest Clin. 2007;59(2):112-5.

  15. Torres J, Leal-Herrera Y, Perez-Perez G, et al. Acommunity-based seroepidemiologic study of Helicobacter pylori infection in Mexico. J Infect Dis. 1998;178(4):1089-94.

  16. Godeau, B, Chevret S, Varet B, et al. Intravenous immunoglobulin or high-dose methylprednisolone,with or without oral prednisone, for adults with untreated severe autoimmune thrombocytopenic purpura: a randomised, multicenter trial. Lancet. 2002;359(9300):23-9.

  17. Rodeghiero F, Ruggeri M. ITP and international guidelines: what do we know, what do we need? Presse Med 2014;43:e61-7.




2020     |     www.medigraphic.com