The acute platelet response to Intravenous Gammaglobulin (
IVIG) has been reported to predict response to subsequent
splenectomy of patients with
ITP. The current study was undertaken to determine if the platelet response to IV
anti-D (Winrho-SDF) predicts response to subsequent
splenectomy. The 61 HIV-uninfected children and adults in this study had taken part in the pre-licensing studies of IV
anti-D and were all those who not only had evaluable platelet responses to IV
anti-D but also had undergone
splenectomy and had information available describing its 1-year outcome. Results of treatment with
IVIG were available in 38 of these 61 patients. Neither response to the initial infusion of IV
anti-D, nor response to the initial or last
IVIG, predicted the response in either children or adults to subsequent
splenectomy. However, response to the last
anti-D infusion in adults was strongly correlated (P = 0.003) to response to subsequent
splenectomy as was
hemolysis >/=2.0 gm/dl after IV
anti-D (P = 0.03). There was no overall relationship between response to IV
anti-D or
IVIG, and response to subsequent
splenectomy. However, a good platelet response in adults to the last IV
anti-D and a
hemoglobin decrease >/=2.0 gm/dl both appeared to predict response to subsequent
splenectomy.