Clinical Features and Results
Between January 2010 and January 2020, the number of patients using IVIGs was 166. Of these patients, 71 were female (42.8%) and 95 were male (57.2%). Indications for IVIGs were listed as follows. Immune thrombocytopenic purpura (ITP), chronic lymphocytic leukemia (CLL), autoimmune hemolytic anemia (AIHA), myelodysplastic syndrome (MDS), aplastic anemia (AA), combined variable immune deficiency syndrome (CVID), acute myeloid leukemia (AML) lymphoblastic leukemia (ALL), Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), myelofibrosis, Waldenström macroglobulinemia (WM), hairy cell leukemia (HCL), pure red cell aplasia (PRCA), acquired immune deficiency syndrome (AIDS), systemic lupus erythematosus (SLE), Castleman Disease, sickle cell anemia and lung cancer. The wide range of diseases in our study is explained as follows: Patients who applied to the emergency department or hematology outpatient clinic with thrombocytopenia and who were treated as immune thrombocytopenic purpura at first and who took IVIG together with glucocorticosteroids according to the emergency treatment plan, received different diagnoses after their advanced examinations. Therefore, patients were divided into two groups: Those who were diagnosed before or after using IVIGs.
It is underlined that an approval has been obtained at the point of using IVIGs in indications not included in the health safety system and hea
It is important to note that different doses of glucocorticosteroids have been used together in all cases of thrombocytopenia, which are thought to be of immune origin. Patients with the diagnosis of ITP were refractory cases under different doses of glucocorticoids, also it was observed that similarly different doses of glucocorticoids were used together with IVIG. Except for steroids, there was no patient diagnosed with ITP who received another type of immunosuppressive. For a autoimmune hemolytic anemia patient, methylprednisolone was used in doses that were tried to be reduced starting from 1 mg/kg for 2 months. Afterwards, weekly rituximab treatment was started due to recurrence; but there was no response.
66 of 166 patients were diagnosed with ITP (39.8%), 19 CLL (11.4%), 1 autoimmune hemolytic anemia (0.6%), 8 MDS (4.8%), 5 aplastic anemia (3%), 3 CVID (1.8%), 11 AML (6.6%), 8 ALL (4.8%), 4 Hodgkin lymphoma (2.4%), 14 non-Hodgkin lymphoma (8.4%), 14 myeloma (8.4%), 1 myelofibrosis (0.6%), 1 Waldenström macroglobulinemia (0.6%), 1 Hairy Cell Leukemia (0.6%), 2 PRCA (1.2%), 3 AIDS (1.8%), 1 SLE (0.6%), 1 Castleman Disease, 2 sickle cell anemia (1.2%) and 1 lung cancer. Disease and gender distribution of the patients are given in Table 1. We should emphasize that all patients for whom IVIGs were used before getting primary diagnosis were thrombocytopenic. This usage was indicated in emergency conditions and emergency treatment. In this context, we see that the number of patients who were used IVIG before getting a primary diagnosis was 79 (47.6%) and 41 of whom (51.9%) were diagnosed with immune thrombocytopenic purpura. In the remaining distribution, 2 patients were diagnosed with KLL (2.5%), 7 patients with MDS (8.9%), 5 patients with aplastic anemia (6.3%), 7 patients with AML (8.9%), 7 patients with ALL (8.9%), 7 patients with NHL (8.9% ), 1 patient with lung cancer (1.3%), 1 patient was myelofibrosis (1.3%), and 1 patient was diagnosed with AIDS (1.3%). Patients and their clinical-gender distributions are given in