{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:40:12Z","timestamp":1792374012626,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Corticosteroids are commonly used as first\u2010line therapy for immune thrombocytopenia (ITP) to suppress immune\u2010mediated platelet destruction. However, some patients fail to respond, and prolonged use is associated with significant adverse effects, necessitating alternative therapeutic modalities. The aim of this study was to evaluate the role of Cluster of differentiation (CD)19\n                    <jats:sup>+<\/jats:sup>\n                    CD38\n                    <jats:sup>+<\/jats:sup>\n                    B cells with presumed regulatory potential as exploratory prognostic markers of steroid\u2010induced response in treatment\u2010na\u00efve adult ITP patients. This prospective cohort study included 37 adults with newly diagnosed primary ITP treated with a standardised dexamethasone regimen at a single centre between November 2021 and June 2023. CD19\n                    <jats:sup>+<\/jats:sup>\n                    CD38\n                    <jats:sup>+<\/jats:sup>\n                    B cells were quantified using flow cytometry. Treatment response at 12\u2009weeks was assessed. Multivariate logistic regression analysis was performed to determine independent prognostic markers of response. Complete response was achieved in 43% of patients, while 57% had steroid\u2010refractory disease. Univariate analysis identified baseline platelet count, bleeding manifestations, age and response time as significant factors. Multivariate analysis demonstrated that a higher baseline percentage of CD19\n                    <jats:sup>+<\/jats:sup>\n                    CD38\n                    <jats:sup>+<\/jats:sup>\n                    cells independently predicted steroid\u2010induced remission (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Receiver operating characteristic (ROC) analysis identified a cut\u2010off value &gt;2.6% for predicting remission (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). Baseline CD19\n                    <jats:sup>+<\/jats:sup>\n                    CD38\n                    <jats:sup>+<\/jats:sup>\n                    B\u2010cell levels may serve as a useful biomarker for predicting steroid response in ITP.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70895","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:06:00Z","timestamp":1792371960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>CD19<\/scp>\n                    +\n                    <scp>CD<\/scp>\n                    38+ regulatory B lymphocytes as exploratory prognostic markers of steroid\u2010induced remission in treatment\u2010na\u00efve adult immune thrombocytopenia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9977-4003","authenticated-orcid":false,"given":"Noreen M.","family":"Elbayoumi","sequence":"first","affiliation":[{"name":"Hematology Unit, Internal Medicine Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May A.","family":"Denewer","sequence":"additional","affiliation":[{"name":"Hematology Unit, Internal Medicine Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1242-1715","authenticated-orcid":false,"given":"Omnia","family":"Khaled","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3144-5128","authenticated-orcid":false,"given":"Nashwa K.","family":"Abousamra","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Azmy","sequence":"additional","affiliation":[{"name":"Hematology Unit, Internal Medicine Department, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201006\u2010225565"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000574"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19079"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19144"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.70242"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2018.11.008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2020.07.016"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2009.11.009"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20101\u20100716\u20101237\u20108_5"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI85113"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2013.03.011"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.218883"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1215216"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010975"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.5045\/br.2022.2022038"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18670"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/16078454.2021.2003066"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000518744"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010008\u20100537\u20101"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14970"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102141.2001.03109"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2024.03.008"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102022\u2010168118"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19199"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153403"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201007\u2010162503"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/571302"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102012\u201005\u2010432575"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/1545\u20105017.70067"}],"container-title":["British 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