Clinical Course of Childhood Immune Thrombocytopenic Purpura and Analysis Predicting Factor of Prognosis / 임상소아혈액종양

ABSTRACT

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an acquired bleeding disorder in which the immune system destroys platelets. There were many studies which predicted the factors associated with the prognosis of childhood ITP, but controversies remained. We analyzed the predicting factors associated with the clinical outcome and prognosis of pediatric patients with newly diagnosed ITP in a single institution. METHODS: We reviewed retrospectively the medical records of 170 patients with newly diagnosed ITP at Chungnam National University Hospital (CNUH) from January 2005 to December 2015. The demographics, complete blood count (CBC), leukocyte differential counts and treatment of patients with ITP were reviewed. RESULTS: The median age at diagnosis were 20 months old (range, 0 to 189 months) for acute ITP and 52 months old for chronic ITP. After initial diagnosis of ITP, 20 of 170 patients (11.8%) were later diagnosed as chronic ITP. Age at diagnosis and absolute lymphocyte count (ALC) at diagnosis were statistically correlated with development of chronic ITP. ALC at diagnosis and at discharge were significantly higher in acute ITP patients than chronic ITP patients. We determined that ALC >4,109/μL at diagnosis and ALC >3,825/μL at discharge were associated with platelet recovery after 12 months. CONCLUSION: This study demonstrated that that high ALC at admission and discharge predict a favorable outcome in children with newly diagnosed ITP. Further studies are warranted to validate these findings.