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Title

Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: data from the Intercontinental Cooperative ITP Study Group (ICIS)

Authors
Neunert, Cindy E
Buchanan, George R
Imbach, Paul
Bolton-Maggs, Paula H B
Bennett, Carolyn M
Neufeld, Ellis
Vesely, Sara K
Adix, Leah
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CollaborationWith : Ozsahin, Ayse Hulya
Published in Blood. 2013, vol. 121, no. 22, p. 4457-62
Abstract Long-term follow-up of children with immune thrombocytopenia (ITP) indicates that the majority undergo remission and severe thrombocytopenia is infrequent. Details regarding bleeding manifestations, however, remain poorly categorized. We report here long-term data from the Intercontinental Cooperative ITP Study Group Registry II focusing on natural history, bleeding manifestations, and management. Data on 1345 subjects were collected at diagnosis and at 28 days, 6, 12, and 24 months thereafter. Median platelet counts were 214 × 10(9)/L (interquartile range [IQR] 227, range 1-748), 211 × 10(9)/L (IQR 192, range 1-594), and 215 × 10(9)/L (IQR 198, range 1-598) at 6, 12, and 24 months, respectively, and a platelet count <20 × 10(9)/L was uncommon (7%, 7%, and 4%, respectively). Remission occurred in 37% of patients between 28 days and 6 months, 16% between 6 and 12 months, and 24% between 12 and 24 months. There were no reports of intracranial hemorrhage, and the most common site of bleeding was skin. In patients with severe thrombocytopenia we observed a trend toward more drug treatment with increasing number of bleeding sites. Our data support that ITP is a benign condition for most affected children and that major hemorrhage, even with prolonged severe thrombocytopenia, is rare.
Keywords Acute DiseaseChildChild, PreschoolChronic DiseaseCombined Modality TherapyFemaleFollow-Up StudiesHemorrhage/immunology/therapyHumansImmunoglobulins, Intravenous/therapeutic useInfantInternational AgenciesMalePlatelet CountPlatelet TransfusionProspective StudiesPurpura, Thrombocytopenic, Idiopathic/immunology/therapyRegistries/statistics & numerical dataRemission InductionRetrospective StudiesSeverity of Illness IndexSplenectomySteroids/therapeutic use
Identifiers
PMID: 23550040
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Article (Published version) (908 Kb) - public document Free access
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Research group Plateforme d'oncologie et d'hématologie pédiatrique (907)
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NEUNERT, Cindy E et al. Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: data from the Intercontinental Cooperative ITP Study Group (ICIS). In: Blood, 2013, vol. 121, n° 22, p. 4457-62. https://archive-ouverte.unige.ch/unige:44658

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Deposited on : 2015-01-07

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