Blood Res.  2014 Sep;49(3):187-191. 10.5045/br.2014.49.3.187.

Natural course of childhood chronic immune thrombocytopenia using the revised terminology and definitions of the international working group: a single center experience

• Shim YJ
• Kim UH
• Suh JK
• Lee KS

• KMID: 2172791
• DOI: http://doi.org/10.5045/br.2014.49.3.187

Abstract

BACKGROUND
The immune thrombocytopenia (ITP) criteria were newly standardized by the International Working Group. Thus, we analyzed the natural course of childhood chronic ITP to predict the prognosis based on the revised criteria.
METHODS
The medical records of children with chronic ITP from May 2000 to February 2013 in our institute were reviewed.
RESULTS
Forty-seven children with chronic ITP who were not undergoing corticosteroid therapy were included. Their initial platelet count was 23+/-25x10(9)/L, and age at diagnosis was 6.3+/-4.1 years. The follow-up period was 5.4+/-3.7 years. Among them, 44.7% (21/47) showed spontaneous remission and maintained a platelet count > or =100x10(9)/L. And 66.0% (31/47) maintained a platelet count > or =50x10(9)/L until the last follow-up date. The time periods required for the platelet count to be maintained > or =50x10(9)/L and > or =100 x10(9)/L were 3.1+/-2.7 and 3.6+/-2.7 years. Age at diagnosis in the > or =50x10(9)/L group (5.7+/-4.4 years) was significantly lower than the age at diagnosis in the <50x10(9)/L group (7.4+/-3.3 years) (P=0.040). And follow-up period was the factor influencing prognosis between the > or =100x10(9)/L group and <50x10(9)/L group (P=0.022).
CONCLUSION
Approximately 45% of children with chronic ITP recovered spontaneously about 3-4 years after the diagnosis and 2/3 of patients maintained a platelet count > or =50x10(9)/L, relatively safe state. Age at diagnosis of ITP and follow-up period were the factors influencing prognosis in this study.

Keyword

Chronic immune thrombocytopenia; Prognosis; Children

MeSH Terms

Child
Diagnosis
Follow-Up Studies
Humans
Medical Records
Platelet Count
Prognosis
Remission, Spontaneous
Thrombocytopenia*

Figure

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  Fig. 1 Time required for the platelet count to reach ≥50×109/L and ≥100×109/L in Group A patients whose initial platelet count was <50×109/L (N=17).

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