Long-term outcome of chronic idiopathic thrombocytopenic purpura in children.
OBJECTIVE
Children with chronic idiopathic thrombocytopenic purpura (ITP) generally have a favorable outcome, but it is not known whether there are any prognostic factors to predict outcome. The objectives of this study were to assess the spontaneous remission rate and the prognostic significance of age, gender, initial platelet count, initial treatment, and response to treatment.


METHODS
In this retrospective review of 62 consecutive children with chronic ITP, 37 were girls and 27 were 10 years of age or older (median age 9 years; range, 0.75-19).


RESULTS
Thirty-five patients (56%) achieved spontaneous remission (remission without splenectomy), 30 of them (48%) within 4 years from diagnosis. Twenty-eight (45%) were complete remissions (platelet counts of >/=100,000) and 7 (11%) were partial remissions (50,000-99,000). There was no significant difference in the spontaneous remission rate between the younger (<10 years) and older children (55.8% vs. 57.1%, P = 0.95) or between boys and girls (56% vs. 56.7%, P = 0.98). Similarly, platelet count at initial diagnosis, initial therapy, or response to initial therapy did not have any prognostic significance. All 14 patients who underwent splenectomy achieved complete remission.


CONCLUSIONS
More than 50% of children with chronic ITP achieve spontaneous remission. Age, gender, platelet count at initial diagnosis, initial treatment, and response to initial treatment do not have any prognostic significance toward the outcome of chronic ITP.
Jayabose
Somasundaram
S
Department of Pediatrics, New York Medical College, Valhalla, New York, USA. s_jayabose@nymc.edu
Levendoglu-Tugal
Oya
O
Ozkaynkak
Mehmet F
MF
Visintainer
Paul
P
Sandoval
Claudio
C
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D012074:Remission Induction; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome