Outcome of chronic idiopathic thrombocytopenic purpura in children

Abstract

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.

2011 yılında çocukluk çağı immün trombositopenik purpura hastalığı izlem ve tedavisinde değişiklikler

“…Therefore, this period was prolonged to one year. In addition, the probability of spontenous improvement in chronic ITP is 30% at the fifth year and 44% at the 10th year (14).…”

Chronic Immune Thrombocytopenia in Children: Who Needs Splenectomy?

“…Even though childhood ITP is typically a benign disorder, 6,8 it can have a negative impact on the child and his or her family. The complexity resides in the management goal to be achieved: Improve the child's quality of life?…”

“…Long-term remission is achieved in more than two thirds of adults 1 and children, 2 with a probably low risk of short-and longterm severe adverse events as compared to splenectomy for other benign hematologic disorders. 3,4 However, in many pediatric cases the benefit of splenectomy does not overcome its disadvantages, because of the low risk of life-threatening bleeding in ITP, the potential of spontaneous improvement or even recovery in 26%-44% of chronic ITP cases, 5,6 the immediate risks of surgery, the long-term risks of overwhelming sepsis especially in the young, and the burden of splenectomized individuals, including administration of oral antibiotics, vaccinations, and medical interventions in case of fever. In a retrospective analysis of 270 children with chronic ITP, defined by a duration of more than 46 months, Bansal et al estimated predicted spontaneous remission rates of 30% and 44% at 5 and 10 years, respectively.…”

“…The probability of remission was higher in children o8 years of age (51.2% at 10 years) and girls (39.6% at 5 years). 6 Although bleedings are mostly benign, 7 the recommendations of restrictions in daily social activities represent a major problem. Severe bleedings are very rare 6,8 ; still, the fear of serious hemorrhages can considerably disturb the quality of life of patients and their families, resulting in the strong desire for platelet-enhancing treatment.…”

Chronic Idiopathic Thrombocytopenic Purpura in children: predictive factors and outcome

“…This observation is relevant in view of the clinical history of these patients, as none of them showed any severe complication. It provides the opportunity to adopt a "wait and see" policy, indicating the use of symptomatic treatments instead of splenectomy as first line treatment; splenectomy should be reserved for selected cases who do not respond to medical treatment and have severe hemorrhagic manifestations [14][15][16].…”