Immunological Markers in Adult Patients With Immune Thrombocytopenic Purpura

Study Overview
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Brief Summary
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The aim of this study is to determine histological immunological parameters, sought on splenectomy pieces that may explain the failure or success of splenectomy in patients with ITP who had a splenectomy to treat their ITP(Immune thrombocytopenic purpura).

Detailed Description
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Immune thrombocytopenic purpura (ITP) is a rare autoimmune thrombocytopenia whose incidence is 2 to 5 cases / 100,000 inhabitants / year. The potentially serious haemorrhagic risk is the major issue of management. A recent international consensus conference classifies PTI according to the duration of thrombocytopenia: acute ITP (<3 months), persistent ITP (3-12 months) and chronic ITP (> 12 months) (Rodeghiero 2009). In the acute or persistent phase, polyvalent immunoglobulins (IVIG) and / or corticosteroids are proposed. In the chronic phase, splenectomy is a possible cure for 70% of patients. No predictor of treatment response is known. The pathophysiology of ITP is multifactorial: platelet phagocytosis, mediated by autoantibody, macrophages of the reticuloendothelial system, and destruction in the spleen, genetic background and / or environmental factor favoring the role of certain lymphocyte subpopulations, cytotoxic or regulatory T, via their cytokine environment, abnormalities of thrombopoiesis. At present, no predictive factor of splenectomy success has been identified. The aim of this study is to determine histological immunological parameters, sought on splenectomy pieces that may explain the failure or success of splenectomy in patients with ITP who had a splenectomy to treat their ITP.

Official Title
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Retrospective Study of Splenic Immunological Markers as Predictive Factors for Response to Splenectomy in Adult Patients Affected by a Immune Thrombocytopenic Purpura

Conditions
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Immune Thrombocytopenic Purpura, Splenectomy; Status

Intervention / Treatment
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* Procedure: Immunolabeling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The analyzed spleens belong to the collection of biological samples declared to the ministry by the Laboratory of Pathology of Haut-Lévêque Hospital (Dr Parrens). Exclusion Criteria: Opposition of the patient.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ITP group<br>On frozen spleens of already splenectomized adult ITP patients. | Procedure: Immunolabeling<br>* Immunolabeling of abnormalities observed by the cell study in flow cytometry.<br>|
| Control group<br>On frozen control spleens from patients who had a splenectomy at the Bordeaux University Hospital following a road accident. | Procedure: Immunolabeling<br>* Immunolabeling of abnormalities observed by the cell study in flow cytometry.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete remission (CR) after splenectomy. | Determination of ITP status following Rodeghiero criteria : complete remission if platelet count > 100 G/L. patient who is not on complete remission after splenectomy will be considered to be failing. | At the inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Immunological parameters, Histological parameters