Chronic immune thrombocytopenic purpura in children: a survey of the canadian experience.
BACKGROUND
Immune thrombocytopenic purpura (ITP) in children is a common pediatric bleeding disorder with heterogeneous manifestations and a natural history that is not fully understood. To better understand the natural history of chronic ITP and detect response trends and outcomes of therapy, we conducted a 10-year retrospective survey of children from age 1 to 18 years with a diagnosis of chronic ITP.


RESULTS
Data on 198 patients from 8 Canadian Pediatric Hematology/Oncology centers were analyzed. The majority of patients were female (58%), and were previously diagnosed with acute (primary) ITP (85%). The age at diagnosis of chronic ITP ranged from 1.1 to 17.2 years with a mean of 8.2+/-4.4 years. Ninety percent of patients received some form of treatment. Untreated patients had a higher mean platelet count at diagnosis of chronic ITP (P=0.009) despite similarities in mean age at first presentation and mean duration of follow-up. Thirty-four (17%) patients underwent splenectomy. Splenectomized patients tended to be significantly older, had a lower mean platelet count at diagnosis of chronic ITP, and had a longer duration of follow-up.


CONCLUSIONS
The results from this study are consistent with published reports.
Belletrutti
Mark
M
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Alberta, Canada. mfb10@ualberta.ca
Ali
Kaiser
K
Barnard
Dorothy
D
Blanchette
Victor
V
Chan
Anthony
A
David
Michele
M
Luke
Brian
B
Price
Victoria
V
Ritchie
Bruce
B
Wu
John
J
D000293:Adolescent; D017668:Age of Onset; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000453:epidemiology* / Q000601:surgery; D012737:Sex Factors; D013156:Splenectomy