Predictive factors for resolution of childhood immune thrombocytopenia: Experience from a single tertiary center in Thailand

Pediatr Blood Cancer. 2017 Jan;64(1):128-134. doi: 10.1002/pbc.26178. Epub 2016 Aug 30.

Abstract

Background: Initial clinical factors that can reliably predict a successful within-1-year resolution of childhood immune thrombocytopenia (ITP) are still unclear. This study aimed to determine factors associated with within-12-month resolution of newly diagnosed childhood ITP.

Methods: The hospital records of 417 consecutive children aged less than 15 years with ITP were reviewed retrospectively and data related to the initial presentation were noted. Logistic regression analysis was used to determine which presenting features were associated with a favorable outcome within 12 months.

Results: Significant clinical and laboratory predictors for resolution of newly diagnosed childhood ITP within 12 months were abrupt onset less than 14 days, age less than 5 years, and platelet count at 4 weeks postdiagnosis of at least 100 × 109 l-1 . With these three significant predictors, the rate of within-1-year recovery was more than 97.2%, with a positive predictive value of 97.8% for newly diagnosed childhood ITP.

Conclusion: Age less than 5 years, onset of bleeding less than 14 days, and follow-up platelet count at 4 weeks of at least 100 × 109 l-1 are significant predictive factors for disease resolution among children with newly diagnosed ITP.

Keywords: ITP resolution; childhood ITP; childhood immune thrombocytopenia; predictive factor of ITP resolution.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hemorrhage / diagnosis*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Infant
  • Infant, Newborn
  • Male
  • Platelet Count
  • Prognosis
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis*
  • Purpura, Thrombocytopenic, Idiopathic / epidemiology
  • Purpura, Thrombocytopenic, Idiopathic / therapy*
  • Retrospective Studies
  • Tertiary Care Centers
  • Thailand / epidemiology

Substances

  • Immunoglobulins, Intravenous