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Predictors for and outcomes after bone marrow biopsy in Scandinavian patients with chronic immune thrombocytopenia
Author(s) -
Gotschalck Madeleine Andersson,
Nørgaard Mette,
Risbo Nickolaj,
Christiansen Christian Fynbo,
Bahmanyar Shahram,
Ghanima Waleed,
Alam Naufil,
Frederiksen Henrik,
Nielson Carrie M.,
Sørensen Henrik Toft
Publication year - 2021
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13635
Subject(s) - medicine , hazard ratio , incidence (geometry) , splenectomy , cancer , platelet , population , medical record , bone marrow , gastroenterology , confidence interval , physics , spleen , environmental health , optics
Objectives To examine predictors for bone marrow biopsy (BMB) and the outcome following BMB in patients with chronic immune thrombocytopenia (cITP). Methods We identified patients diagnosed with cITP during 2009‐2017 and obtained information on BMB, cITP treatment and subsequent thrombotic events, hospitalized bleeding, hematological cancer, and death using data from population‐based healthcare databases and medical records in Denmark, Norway, and Sweden. Results Among 4471 adults (≥18 years) with cITP, 1683 (37.6%) underwent BMB before cITP diagnosis, while cumulative BMB incidence after cITP diagnosis date was 3.1% at 1 year and 7.5% at 5 years. Predictors of having a BMB after cITP diagnosis included older age, male sex, low baseline platelet count, splenectomy, and number of cITP treatments. Compared with patients without BMB, patients with BMB had higher rates of thrombotic events (1 year adjusted hazard ratio [HR] 1.53 [95% CI, 0.92‐2.54]), hospitalized bleeding episodes (1 year adjusted HR 1.72 [95% CI, 1.15‐2.58]), hematological cancer (1 year adjusted HR 35.26 [95% CI 17.67‐70.34]), and all‐cause mortality (1 year adjusted HR 1.97 [95% CI, 1.44‐2.68]). Conclusion Patients who undergo BMB after cITP diagnosis represent a subset of patients with more severe disease and increased rates of complications as well as hematological malignancies.