title: [Classification therapy in 405 children with immune thrombocytopenia].
abstract: OBJECTIVE
  To explore the efficiency and safety of immune thrombocytopenia（ITP）in children through classification treatment.
  
  
  METHODS
  405 newly diagnosed ITP patients were enrolled in this study from January 1st 2013 to August 31st 2014. The cases were divided into observation group and therapy group according to the initial platelet count of less than 20×10⁹/L or the cases of active bleeding. There were 104 male cases and 76 female cases in observation group with the media platelet count of 46 （20-89）×10⁹/L. They were followed up with a median of 20 months. The therapy group，including 131 males and 94 females with a median platelet count of 11（1-19）×10⁹/L, were followed up by 22 months.
  
  
  RESULTS
  The total curative rate at acute period was 80.44%（181/225）in therapy group with the first line treatment. In observation group, 148 cases（82.22%）reached complete response（CR）or response（R） criteria. 44 patients came into persistent period with an effective rate of 34.09%（15/44）in therapy group. The overall effectiveness over one year was 87.11%（196/255）. In observation group, 32 cases came into persistent period and 13 cases（40.63%）got the CR or R line. After one year of observation, 161 cases （89.44%）reached the CR or R standard. In therapy group, 5 out of 29 patients（17.24%）in chronic period got CR or R. While in observation group, 6 out of 19 cases（31.58%）reached the CR or R standard. The elder children over 10 years had risk factors in response in two groups. There was no severe bleeding or adverse effect or dead cases in this study.
  
  
  CONCLUSIONS
  It is reasonable to take platelet count <20×10⁹/L and（or）active bleeding as the dividing line for classification therapy indications. Nearly half of the cases could avoid over therapy and decreased the risk of drugs side effect to improve life quality.
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Shao
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Qidong
authors.initials: Q
authors.lastname: Ye
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
mesh_terms: D002648:Child; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008297:Male; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000145:classification* / Q000628:therapy*; D011788:Quality of Life; D012074:Remission Induction; D012307:Risk Factors