Absolute lymphocyte count and risk of short-term infection in patients with immune thrombocytopenia.
Patients with immune thrombocytopenia (ITP) may be at increased risk of infection because of the steroids and other immunosuppressive agents used in its treatment. This study aimed to identify events that are associated with infection within 6 months of diagnosis and the impact that infection has on survival. We retrospectively evaluated 239 patients (107 men, 132 women; median age 61 years) diagnosed between January 1997 and August 2011. Every patient received steroid treatment according to the platelet count and the extent of bleeding. Logistic regression analysis was used to identify risk factors associated with the development of infection within 6 months of ITP being diagnosed. Sixty-two patients (25.9 %) developed an infection within 6 months of diagnosis. Multivariate analysis revealed that a lower absolute lymphocyte count (ALC) at diagnosis (<1 × 10(9)/l) was an independent risk factor for infection (P = 0.039; 95 % confidence interval, 1.033-3.599; odds ratio, 1.928). The time to infection event is significant shorter in those of low ALC, compared with those of higher ALC (P = 0.032). Furthermore, the 1-year mortality rate after ITP diagnosis was significantly higher in those patients who developed an infection (P = 0.001). ITP patients with a low absolute lymphocyte count at diagnosis have an increased risk of infection, and those who develop infections have lower 1-year survival.
Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Beitou Dist., Taipei City, 11217, Taiwan, Republic of China.
Ming-Hung
MH
Hu
Yuan-Bin
YB
Yu
Yu-Chung
YC
Huang
Jyh-Pyng
JP
Gau
Liang-Tsai
LT
Hsiao
Jin-Hwang
JH
Liu
Ming-Huang
MH
Chen
Tzeon-Jye
TJ
Chiou
Po-Min
PM
Chen
Cheng-Hwai
CH
Tzeng
Chun-Yu
CY
Liu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007239:Infections / Q000209:etiology*; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D013156:Splenectomy; D016896:Treatment Outcome; D055815:Young Adult
D008775:Methylprednisolone