Immune Thrombocytopenia in Children: Consensus and Controversies

Singh, G.; Bansal, Deepak; Wright, Nicola

doi:10.1007/s12098-019-03155-4

Cited by 19 publications

(26 citation statements)

References 50 publications

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“…3 With an estimated incidence of 4.2 per 100 000 person-years, it is the most common type of thrombocytopenia in children. 4 ITP can be classified by disease duration as newly diagnosed (,3 months), persistent (3-12 months), or chronic (.12 months). 1,2 Severe bleeding mostly…”

Section: Introductionmentioning

confidence: 99%

Spotlight on eltrombopag in pediatric ITP in China: a long-term observational study in real-world practice

Cheng¹,

Fu²,

Ma³

et al. 2021

Blood Advances

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Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder with isolated thrombocytopenia and risk of hemorrhage. Treatment with eltrombopag increases and maintains hemostatic platelet counts; however, to date, long-term data are lacking on the outcome of children with ITP who are treated with eltrombopag. This prospective, observational, longitudinal cohort study evaluated the efficacy and safety of eltrombopag in pediatric patients with persistent or chronic ITP. For the 116 pediatric patients enrolled, duration of eltrombopag treatment was at least 3 months. Median effective dose was 25 mg/day, 50 mg/day, and 50 mg/day, respectively, for children age 5 years or younger, 6 to 11 years, or 12 years or older. In all, 89 patients (76.7%) achieved overall response, 53 (45.7%) achieved complete response, and 36 (31.0%) achieved response. Median platelet counts increased by week 1 and were sustained throughout the treatment period. During treatment with eltrombopag, the proportion of patients with grade 1 to 4 bleeding symptoms decreased from 83.61% at baseline to 9.88% at 6 months when only grade 1 was reported. Forty-three patients (37.1%) reported using concomitant medications at study entry, which was reduced to 1 patient (2.5%) who needed concomitant medications at 12 months. All adverse events were grade 1 or 2 according to Common Terminology Criteria for Adverse Events. No serious adverse events, cataracts, malignancies, or thromboses were reported during the study. Long-term treatment with eltrombopag was generally safe, well tolerated, and effective in maintaining platelet counts and reducing bleeding in most pediatric patients with persistent or chronic ITP. Combined with future studies, these findings will help establish how eltrombopag should best be used in the management of pediatric patients with East Asian ancestry.

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Section: Introductionmentioning

confidence: 99%

Spotlight on eltrombopag in pediatric ITP in China: a long-term observational study in real-world practice

Cheng¹,

Fu²,

Ma³

et al. 2021

Blood Advances

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“…G.R Buchanan [9] additionally found that 27% of cases created constant ITP. Singh et al, [10] found that ongoing ITP addresses 15-20 % of cases.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study for Immune Thrombocytopenia Outcome in Children in Benha

Abouamer

Motaleb

Eid

et al. 2021

Benha Journal of Applied Sciences

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“…3 ITP is considered to be related to abnormalities in the immune system, and arises when autoantibodies directed against platelet antigens result in increased clearance of platelets by the mononuclear macrophage system from the peripheral circulation. [4][5][6][7] The incidence of ITP in adults is between 3.3 and 3.9 per 100,000 per year, and that of children is between 1.9 and 6.4 per 100,000. 8,9 While a brief course with spontaneous remission is frequently observed in most children with ITP, some patients transform to the chronic phenotype.…”

Section: Introductionmentioning

confidence: 99%

Use of bioinformatic analyses in identifying characteristic genes and mechanisms active in the progression of idiopathic thrombocytopenic purpura in individuals with different phenotypes

Zhang

2020

J Int Med Res

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Objective To explore the mechanism underlying the progression of newly diagnosed idiopathic thrombocytopenic purpura (ITP) to its chronic or remission state using bioinformatic methods. Methods GSE56232 and GSE46922 gene expression profile datasets were downloaded from Gene Expression Omnibus (GEO). Differentially expressed genes were identified and characteristic genes were screened by weighted gene co-expression network analysis. These genes were used for function enrichment analysis and construction of a protein–protein interaction network. Finally, characteristic genes were verified to determine potential molecular mechanisms underlying ITP progression. Results We found that characteristic genes in the chronic ITP group were mainly involved in intracellular processes and ion binding, while characteristic genes in the remission ITP group were involved in intracellular processes and nuclear physiological activities. We identified a sub-network of characteristic genes, LMNA, JUN, PRKACG, SMC3, which may indicate the mechanism by which newly diagnosed ITP progresses to chronic. Although no meaningful signaling pathways were found, the expression of NR3C1, TPR, SMC4, PANBP2, CHD1, and U2SURP may affect ITP progression from newly diagnosed to remission. Conclusion Our findings improve the understanding of the pathogenesis and progression of ITP, and may provide new directions for the development of treatment strategies.

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Immune Thrombocytopenia in Children: Consensus and Controversies

Cited by 19 publications

References 50 publications

Spotlight on eltrombopag in pediatric ITP in China: a long-term observational study in real-world practice

Spotlight on eltrombopag in pediatric ITP in China: a long-term observational study in real-world practice

Retrospective Study for Immune Thrombocytopenia Outcome in Children in Benha

Use of bioinformatic analyses in identifying characteristic genes and mechanisms active in the progression of idiopathic thrombocytopenic purpura in individuals with different phenotypes

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