Details

Autor(en) / Beteiligte

• Neunert, Cindy E.
• Buchanan, George R.
• Imbach, Paul
• Bolton-Maggs, Paula H.B.
• Bennett, Carolyn M.
• Neufeld, Ellis
• Vesely, Sara K.
• Adix, Leah
• Blanchette, Victor S.
• Kühne, Thomas

Titel

Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: data from the Intercontinental Cooperative ITP Study Group (ICIS)

Ist Teil von

• Blood, 2013-05, Vol.121 (22), p.4457-4462

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Long-term follow-up of children with immune thrombocytopenia (ITP) indicates that the majority undergo remission and severe thrombocytopenia is infrequent. Details regarding bleeding manifestations, however, remain poorly categorized. We report here long-term data from the Intercontinental Cooperative ITP Study Group Registry II focusing on natural history, bleeding manifestations, and management. Data on 1345 subjects were collected at diagnosis and at 28 days, 6, 12, and 24 months thereafter. Median platelet counts were 214 × 109/L (interquartile range [IQR] 227, range 1-748), 211 × 109/L (IQR 192, range 1-594), and 215 × 109/L (IQR 198, range 1-598) at 6, 12, and 24 months, respectively, and a platelet count <20 × 109/L was uncommon (7%, 7%, and 4%, respectively). Remission occurred in 37% of patients between 28 days and 6 months, 16% between 6 and 12 months, and 24% between 12 and 24 months. There were no reports of intracranial hemorrhage, and the most common site of bleeding was skin. In patients with severe thrombocytopenia we observed a trend toward more drug treatment with increasing number of bleeding sites. Our data support that ITP is a benign condition for most affected children and that major hemorrhage, even with prolonged severe thrombocytopenia, is rare. •Severe thrombocytopenia is rare and major hemorrhage is uncommon in children with persistent and chronic ITP.•In children with persistent or chronic ITP, there is a trend toward reserving drug therapy for those experiencing significant bleeding.