Abstract：
OBJECTIVE:To evaluate the impact of the sequence of treatment with rituximab and/or splenectomy on time to relapse for patients with steroid-refractory immune thrombocytopenia (ITP). PATIENTS AND METHODS:Patients 18 years or older with steroid-refractory immune thrombocytopenia who underwent treatment with splenectomy or rituximab from January 1, 2002, through December 31, 2015, at Mayo Clinic. Evaluation included freedom from relapse (FFR) and response rates after treatment with rituximab or splenectomy as single or sequential interventions. RESULTS:A total of 218 eligible patients with ITP who were treated according to standard of care were included in this analysis. Patients failing steroids treated with splenectomy had a higher 5-year FFR than did those treated with rituximab (67.4% vs 19.2%; P<.001, propensity-score matched). Patients who failed splenectomy and were then treated with rituximab had a 2-year FFR similar to that of patients who failed rituximab and were then treated with splenectomy (73.4% vs 59.9%; P=.52). Patients treated with rituximab after splenectomy had a longer 2-year FFR than did patients treated with rituximab as a second-line treatment (73.4% vs 29.0%; P<.001). CONCLUSION:For patients with ITP that relapse after treatment with steroids, splenectomy provides longer FFR than rituximab as a second-line therapy. Among patients who fail second-line treatment with splenectomy or rituximab, those who end up receiving sequential splenectomy-rituximab or rituximab-splenectomy therapy seem to derive similar benefit in the long term. Patients who received rituximab after splenectomy seem to derive superior benefit than do those who are treated with rituximab with an intact spleen.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Hammond WA,Vishnu P,Rodriguez EM,Li Z,Dholaria B,Shreders AJ,Rivera CEdoi
10.1016/j.mayocp.2019.05.024subject
Has Abstractpub_date
2019-11-01 00:00:00pages
2199-2208issue
11eissn
0025-6196issn
1942-5546pii
S0025-6196(19)30506-3journal_volume
94pub_type
杂志文章abstract：OBJECTIVE:To review our institution's experience with patients who failed to benefit from septal artery ablation, which necessitated subsequent septal myectomy, and to examine reasons for ablation failure and outcome of myectomy after ablation. PARTICIPANTS AND METHODS:Of 550 patients who underwent septal myectomy at ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)61096-3
更新日期：2007-12-01 00:00:00
abstract：OBJECTIVE:To prospectively assess the safety and effectiveness of the investigational phosphodiesterase 5 inhibitor avanafil to treat erectile dysfunction in men with diabetes mellitus. PATIENTS AND METHODS:This 12-week, multicenter, double-blind, placebo-controlled study conducted between December 15, 2008, and Febru...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.mayocp.2012.06.016
更新日期：2012-09-01 00:00:00
abstract：:Two-dimensional echocardiography is useful for the immediate diagnosis of acute myocardial infarction when diagnostic electrocardiographic changes are absent. The technique is also helpful in distinguishing myocardial infarction from other conditions that may clinically or electrocardiographically mimic infarction. Th...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61526-2
更新日期：1987-01-01 00:00:00
abstract：:An interactive audio and video telemedicine feasibility program was established to provide counseling on breast cancer risk-reducing strategies for underserved, high-risk Alaskan native women through a collaboration among the Alaska Native Medical Center, the Mayo Clinic Breast Clinic, Mayo's Center for Innovation, an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2012.10.015
更新日期：2013-01-01 00:00:00
abstract：OBJECTIVE:To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating risk-benefit for adjuvant postoperative treatments in high-risk renal cell carcinoma by assessing reported disease-free survival (DFS), overall survival (OS), toxicity, and quality of life. METHODS:A literature...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,meta分析
doi：10.1016/j.mayocp.2019.01.045
更新日期：2019-08-01 00:00:00
abstract：OBJECTIVE:To analyze the influence of recent changes in Minnesota statutes that generally require prior authorization for use of medical records for research from patients who received medical care after Jan. 1, 1997. MATERIAL AND METHODS:In this Mayo Clinic Institutional Review Board-approved study, we obtained a str...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/74.4.330
更新日期：1999-04-01 00:00:00
abstract：:Lyme disease is a multisystem disorder caused by a tick-transmitted spirochete, Borrelia burgdorferi. The diagnosis is based on clinical findings in most patients, particularly those with erythema migrans or exposure to geographic locations endemic for the disease. Detection of a specific antibody to B. burgdorferi is...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65506-2
更新日期：1988-11-01 00:00:00
abstract：:Fibromyalgia is the currently preferred term for widespread musculoskeletal pain, typically accompanied by other symptoms such as fatigue, memory problems, and sleep and mood disturbances, for which no alternative cause can be identified. Earlier there was some doubt about whether there was an "organic basis" for thes...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.03.014
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:To determine the incidence and predictors of infective endocarditis (IE) in a population-based cohort of patients with mitral valve prolapse (MVP). PATIENTS AND METHODS:We identified all adult Olmsted County residents with MVP diagnosed by echocardiography from January 1989 to December 1998 and cross-matched...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.12.006
更新日期：2016-03-01 00:00:00
abstract：:In a retrospective analysis, 63 participants in a cardiac rehabilitation-preventive cardiology program were identified as having low blood concentrations (mean, 34 mg/dl) of high-density lipoprotein cholesterol (HDL-C) and a mean total cholesterol level of 223 mg/dl after 3 months of hygienic measures (aerobic exercis...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章
doi：10.1016/s0025-6196(12)60824-6
更新日期：1992-09-01 00:00:00
abstract：:Low back pain (LBP) is a leading cause of disability worldwide. In the absence of a classification system for pain syndromes, classification of LBP on the basis of the distribution of pain as axial (pain generally localized to the low back) or radicular neuropathic (pain radiating to the lower extremities) is relevant...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.10.009
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:To determine whether the use of a computerized bar code-based blood identification system resulted in a reduction in transfusion errors or near-miss transfusion episodes. PATIENTS AND METHODS:Our institution instituted a computerized bar code-based blood identification system in October 2006. After instituti...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2012.12.010
更新日期：2013-04-01 00:00:00
abstract：:Currently, computer-assisted imaging can visualize very fast or very slow nonvisible motion events. We can create measurable geometric representations of physiology, including transformation, blood flow velocity, perfusion, pressure, contractility, image features, electricity, metabolism, and a vast number of other co...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/74.4.399
更新日期：1999-04-01 00:00:00
abstract：:Health-care organizations have recognized the need to prepare physicians for various leadership and management positions within their own institutions. In the past, those who desired further education had to search beyond the boundaries of their practice to fulfill this need. The demands of a dynamic and changing heal...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63574-X
更新日期：1997-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the treatment strategies for primary and secondary management of malignancy-related pericardial effusions. PATIENTS AND METHODS:Retrospective review of Mayo Clinic Rochester charts and external records of patients with pericardial effusion associated with malignant disease who required treatment ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/75.3.248
更新日期：2000-03-01 00:00:00
abstract：:We describe a woman in whom hypogammaglobulinemia and severe granulomatous cutaneous lesions had developed during childhood; subsequently, Hodgkin's disease and necrobiotic xanthogranuloma were diagnosed. This case illustrates an apparent association with disease activity and raises the question of a direct relationsh...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62473-2
更新日期：1991-12-01 00:00:00
abstract：:In this case of Sertoli cell tumor of the testis, no laboratory or clinical evidence of hormonal imbalance was present. The histologic and ultrastructure characteristic of the tumor agreed closely with previous reports on these rare tumors of the gonadal stroma. ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1975-08-01 00:00:00
abstract：:Primary sclerosing cholangitis (PSC) predisposes to the development of cholangiocarcinoma, a usually fatal complication that is difficult to diagnose. Serum concentrations of CA 19-9, a tumor-associated antigen, are frequently increased in patients with only cholangiocarcinoma. The aim of this study was to assess the ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60696-x
更新日期：1993-09-01 00:00:00
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61876-x
更新日期：1987-02-01 00:00:00
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pub_type： 杂志文章
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pub_type： 杂志文章,评审
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
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pub_type： 杂志文章,评审
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更新日期：2020-07-01 00:00:00
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1977-08-01 00:00:00
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journal_title：Mayo Clinic proceedings
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doi：10.1016/s0025-6196(12)65677-8
更新日期：1989-02-01 00:00:00
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1977-07-01 00:00:00
abstract：:For primary care physicians, obesity is one of the most challenging problems confronted in office practice. The disorder is Increasing in prevalence despite the efforts of both patients and physicians. Treatment requires a multimodality approach that addresses diet, physical activity, and behavioral issues. Medication...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/82.1.93
更新日期：2007-01-01 00:00:00
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pub_type： 杂志文章
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更新日期：2008-01-01 00:00:00
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
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更新日期：2009-12-01 00:00:00
abstract：:The detection of monoclonal light chains in the urine by the Bence Jones heat test is a useful adjuvant to the diagnosis of myeloma and other related diseases. The test is particularly helpful when no serum spike is noted. Overall, it is positive in approximately half of all patients with myeloma. In order to assess t...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1975-05-01 00:00:00
