Evaluation of the Usefulness of Detected Platelet Antibodies for the Prognosis of Treatment Results in Patients with Thrombocytopenic Purpura.

Platelet antibodies are the main cause of platelet destruction in immunological thrombocytopenic purpura. However, the significance of their detection for prognosis of treatment results in ITP patients (idiopathic immune thrombocytopenic purpura) has not yet been determined.

The aim of this work was to evaluate the effectiveness of treatment with corticosteroids, splenectomy and immnunosupressive drugs of 409 ITP patients in relation to the detection of platelet antibodies.

Platelet antibodies were determined in the ITP patients under observation:

in connection with autologous platelets - with platelet immunofluorescence test (PIFT),

in serum - with immunoenzimatic test using monoclonal antibodies directed at GPII/IIIa, GPIb, GPIa/IIa (MAIPA - monoclonal antibody immobilization of platelet antigens).

In treatment effectiveness prognosis the multifactor statistical analysis was used involving not only platelet antibodies but also other parameters such as age, sex, course of disease, megacariocyte count in bone marrow. In patients after splenectomy -the spleen-liver index and the time lapse between ITP diagnosis and surgical procedure were additionally taken into account.

The statistical analysis revealed that platelet antibodies had no significant effect on the treatment results prognosis in ITP patients. However, while analysing groups of patients with different treatment administered, it was found that the effect of platelet antibodies on positive prognosis treatment was significant though not very big effect in the case of patients treated with corticosteroids and immunosuppressive drugs while nonsignificant in the case of patients after splenectomy.

Additional factors significantly effecting positive treatment prognosis in all patients were: severe/acute course of disease, increased/normal megacariocyte count, young age, female sex. In splenectomy patients the spleen-liver index (up to 5.7:1) seems to be a significantly beneficial factor as well as the time lapse between diagnosis and procedure (up to 9 years since diagnosis).