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Outcome of chronic idiopathic thrombocytopenic purpura in children
Author(s) -
Bansal Deepak,
Bhamare Tanmay Anant,
Trehan Amita,
Ahluwalia Jasmina,
Varma Neelam,
Marwaha R.K.
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22346
Subject(s) - medicine , splenectomy , thrombocytopenic purpura , pediatrics , complete remission , retrospective cohort study , spontaneous remission , surgery , platelet , chemotherapy , spleen , alternative medicine , pathology
Background There is paucity of data on long‐term probability of remission in chronic idiopathic thrombocytopenic purpura (ITP). Aim was to study the course and factors influencing remission of chronic ITP. Chronic ITP was defined as thrombocytopenia persisting >6 months following initial diagnosis. Procedures Case‐records of children with chronic ITP, aged <14 years, were reviewed in this retrospective study (1987–2006). Results Two hundred seventy children were followed. Median age at diagnosis was 6 years. Median duration of follow up was 30 months (range 6–166). Isolated thrombocytopenia (even if <10 × 10 9 /L) in the absence of “significant” bleeds, by itself was not considered an indication for drug therapy. Sixty‐seven (24.8%) children attained complete remission (CR) over a median period of 18 months (range 7–120). The probabilities of remission at 5 years for males and females were 24% and 39.6%, respectively ( P = 0.01). The probability of achieving remission at 10 years in children <8 and ≥8 years was 51.2% and 34%, respectively ( P = 0.02). The probability of remission at 5 years for children who received some treatment, versus no treatment was 31.4% and 27%, respectively ( P = 0.8). Nine of 18 children, who underwent splenectomy, achieved CR. Intracranial hemorrhage (ICH) occurred in 11 (4%) cases. The time of occurrence of ICH from onset of symptoms varied from 6 to 55 months. Conclusions The predicted spontaneous remission rate with chronic ITP was 30% and 44% at 5 and 10 years, respectively. Platelet count at diagnosis and the treatment administered did not influence remission outcomes. Age <8 years and female gender were predictors of a favorable outcome. Pediatr Blood Cancer 2010;54:403–407. © 2009 Wiley‐Liss, Inc.