Long-term response to corticosteroid therapy and splenectomy was evaluated in 66 adults with idiopathic thrombocytopenic purpura (ITP). In 75% of 57 patients, a rise in platelet count was observed during administration of corticosteroids. In 49% of the 57, platelet counts of greater than 50,000/cu mm were documented four months after cessation of treatment, and in 37% a sustained remission throughout follow-up periods of 1 to 18 years was seen. Splenectomy produced good or excellent responses in 83% of 35 patients evaluated four months after operation and in all but two patients remission has been sustained during follow-up periods of 1 to 25 years. Prognosis based upon response to the initial course of corticosteroid treatment appears to be more reliable than that based upon duration of symptoms prior to treatment.
Thompson RL, Moore RA, Hess CE, Wheby MS, Leavell BS. Idiopathic Thrombocytopenic Purpura: Long-term Results of Treatment and the Prognostic Significance of Response to Corticosteroids. Arch Intern Med. 1972;130(5):730–734. doi:10.1001/archinte.1972.03650050058010
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