Long-term follow-up of idiopathic thrombocytopenic purpura in 310 patients

Nicola Vianelli, Lelia Valdrè, Mauro Fiacchini, Antonio De Vivo, Luigi Gugliotta, Lucia Catani, Roberto M. Lemoli, Michela Poli, Sante Tura

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Idiopathic thrombocytopenic purpura (ITP) induces thrombocytopenia by means of an autoimmune mechanism. Despite the available therapies a subset of patients develop chronic refractory severe thrombocytopenia (i.e. a platelet count consistently lower than 20 to 30x109/L), and life-threatening bleeding can occasionally occur. It has been suggested that the risk of major bleeding is higher in elderly patients and in patients with bleeding at diagnosis. However, since clear data on the influence of clinical and/or laboratory parameters on outcome are lacking, some patients may be receiving unnecessary treatment. Design and Methods. We made a retrospective analysis of a series of 310 patients with chronic ITP (108 males and 202 females), with a median age at diagnosis of 40 years (range 8-87 years). The median follow-up time was 121 months, (range 7-434 months). Therapy was most often started in the presence of hemorrhagic complications and/or a platelet count 9/L either at diagnosis or during follow-up. Results. Our findings confirmed that patients who were symptomatic at diagnosis were more likely to have bleeding during their follow-up. Moreover, all the patients who suffered major bleeding during their follow-up had median platelet counts of 10x109/L (range 1-20) at that time. Only one patient, aged 43 years, died of hemorrhage following prolonged severe thrombocytopenia. Age >60 years was not associated with any significant differences in incidence of bleeding at diagnosis or during follow-up. Interpretation and Conclusions. We conclude that prospective studies are required to evaluate whether it may be reasonable to treat only symptomatic patients, independently of age.

Original languageEnglish
Pages (from-to)504-509
Number of pages6
JournalHaematologica
Volume86
Issue number5
Publication statusPublished - May 2001

Keywords

  • Elderly patients
  • Idiopathic thrombocytopenic purpura (ITP)
  • Major bleeding
  • Severe symptomatic thrombocytopenia

ASJC Scopus subject areas

  • Hematology

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    Vianelli, N., Valdrè, L., Fiacchini, M., De Vivo, A., Gugliotta, L., Catani, L., Lemoli, R. M., Poli, M., & Tura, S. (2001). Long-term follow-up of idiopathic thrombocytopenic purpura in 310 patients. Haematologica, 86(5), 504-509.