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Prospective evaluation of the first option, second-line Therapy in childhood chronic immune thrombocytopenia: splenectomy or immunomodulation
| dc.rights.license | open | en_US |
| dc.contributor.author | DUCASSOU, S. | |
| dc.contributor.author | FERNANDES, H. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | SAVEL, Helene | |
| dc.contributor.author | BERTRAND, Y. | |
| dc.contributor.author | LEBLANC, T. | |
| dc.contributor.author | CHAHLA, W. A. | |
| dc.contributor.author | PASQUET, M. | |
| dc.contributor.author | LEVERGER, G. | |
| dc.contributor.author | BARLOGIS, V. | |
| dc.contributor.author | THOMAS, C. | |
| dc.contributor.author | BAYART, S. | |
| dc.contributor.author | PELLIER, I. | |
| dc.contributor.author | ARMARI-ALLA, C. | |
| dc.contributor.author | GUITTON, C. | |
| dc.contributor.author | CHEIKH, N. | |
| dc.contributor.author | KHERFELLAH, D. | |
| dc.contributor.author | VASSAL, G. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | THIEBAUT, Rodolphe | |
| dc.contributor.author | LAGHOUATI, S. | |
| dc.contributor.author | ALADJIDI, N. | |
| dc.date.accessioned | 2021-03-16T14:19:14Z | |
| dc.date.available | 2021-03-16T14:19:14Z | |
| dc.date.issued | 2021-04 | |
| dc.identifier.issn | 0022-3476 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/26691 | |
| dc.description.abstractEn | OBJECTIVE: To describe four subgroups of pediatric patients treated with splenectomy, hydroxychloroquine, azathioprine or rituximab as the first-option, second-line treatment for chronic immune thrombocytopenia (cITP). STUDY DESIGN: Selection of patients with cITP from the French national prospective cohort of pediatric autoimmune cytopenia OBS'CEREVANCE and VIGICAIRE study, treated by splenectomy, hydroxychloroquine, azathioprine or rituximab as a first second-line treatment. RESULTS: For 137 patients, treated between 1989 and 2016, the median follow-up after diagnosis and after treatment initiation was 8.5 (2.8-26.4) years and 4.7 (1.1-25.1) years respectively. Median age at diagnosis and at initiation of treatment were 9 (0.7; 16) and 12 (2; 18.1) years respectively without significant difference between subgroups. For the whole cohort, 24-month event-free survival (EFS) was 62% (95%CI: 55; 71). It was 85% (95%CI: 77; 95) for the 56 splenectomized patients, 60% (95%: 44; 84) for the 23 patients treated with rituximab, 46% (95%CI: 30; 71) for the 24 patients treated with azathioprine and 37% (95%CI: 24; 59) for the 34 patients treated with hydroxychloroquine (Log-rank P < .0001). For the splenectomy subgroup, being older than 10 years at splenectomy tended to improve EFS (p = 0.05). Female teenagers with ANA positivity benefited from hydroxychloroquine therapy. CONCLUSION: This national study, limiting pitfalls in the analysis of the effects of second-line therapies, showed that splenectomy remains the treatment associated with the better response at 24 months. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Children | |
| dc.subject.en | Second-line treatment | |
| dc.subject.en | Rituximab | |
| dc.subject.en | Hydroxychloroquine | |
| dc.subject.en | Azathioprine | |
| dc.title.en | Prospective evaluation of the first option, second-line Therapy in childhood chronic immune thrombocytopenia: splenectomy or immunomodulation | |
| dc.title.alternative | J Pediatr | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1016/j.jpeds.2020.12.018 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 33340549 | en_US |
| bordeaux.journal | Journal of Pediatrics | en_US |
| bordeaux.page | 223-230 | |
| bordeaux.volume | 231 | |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.team | USMR | en_US |
| bordeaux.team | SISTM_BPH | |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.export | false | |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20Pediatrics&rft.date=2021-04&rft.volume=231&rft.spage=223-230&rft.epage=223-230&rft.eissn=0022-3476&rft.issn=0022-3476&rft.au=DUCASSOU,%20S.&FERNANDES,%20H.&SAVEL,%20Helene&BERTRAND,%20Y.&LEBLANC,%20T.&rft.genre=article |
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