title: High Remission Rate of Chronic Immune Thrombocytopenia in Children: Result of 20-Year Follow-Up.
abstract: OBJECTIVE
  This study examined the outcomes of children with chronic immune thrombocytopenia (ITP).
  
  
  METHODS
  We retrospectively analyzed the medical records of all patients diagnosed with ITP from January 1992 to December 2011 at our institution.
  
  
  RESULTS
  A total of 128 patients (64%) satisfied the criteria for newly diagnosed ITP, 31 (15%) for persistent ITP, and 41 (21%) for chronic ITP. The median age at diagnosis was 4.5 years (range, 1 month to 18 years). The median platelet count at diagnosis was 32×10⁹/L. A comparison of the initial treatment data from 2001 to 2011 with those from 1992 to 2000 showed that the number of bone marrow examinations decreased, whereas observation increased. Chronic ITP presented at an older age than newly diagnosed and persistent ITP (6.6 years vs. 3.8 years vs. 4.1 years, respectively); however, the difference did not reach statistical significance (p=0.17). The probability of complete remission of chronic ITP was 50% and 76% at 2 and 5 years after diagnosis, respectively. Patients aged <1 year at diagnosis had a significantly better prognosis than did older patients (hazard ratio, 3.86; p=0.02).
  
  
  CONCLUSIONS
  Children with chronic ITP showed a high remission rate after long-term follow-up. This study suggests that invasive treatments such as splenectomy in children with chronic ITP can be delayed for 4 to 5 years if thrombocytopenia and therapeutic medication do not affect the quality of life.
authors.affiliation: Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea.
authors.forename: Chae Young
authors.initials: CY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea. snoopyi@hanmail.net.
authors.forename: Hoi Soo
authors.initials: HS
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010976:Platelet Count; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000188:drug therapy; D011788:Quality of Life; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Immune thrombocytopenia; children; chronic; complete remission