Preview

Вопросы гематологии/онкологии и иммунопатологии в педиатрии

Расширенный поиск

Prognostic evaluation of immune thrombocytopenia outcomes in Egyptian children: a retrospective single-center experience

https://doi.org/10.24287/1726-1708-2021-20-3-26-30

Полный текст:

Аннотация

Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children. This retrospective study was designed to analyze presenting features of ITP cases in Benha, evaluate outcomes in children and determine prognostic factors. This research was accepted by Research Ethics Committee (REC) of Faculty of Medicine, Benha University (chairman: Prof. Nermeen Adly Mahmoud). Ethics comittee refrence number MS 40-3/2019. Records of 308 children with ITP in Benha University Hospitals and Benha Children Hospital haematology clinics between May 2014 and January 2021 were retrospectively analyzed. Socio-demographic, clinical, and laboratory data of the studied children such as age, gender, the type of residence, the date of diagnosis, complaints at presentation, preceding vaccination or infection, the type of bleeding, initial platelet count, LDH (lactate dehydrogenase) level, initial treatment, and outcomes were recorded. A total of 308 children diagnosed with ITP were included, clinical courses were determined as newly diagnosed and chronic in 71.4% and 28.6%, respectively. The median age of patients at diagnosis was 5 ± 3.4 years. The male/female ratio was 1.14. The median age at diagnosis was significantly higher in chronic ITP patients (p < 0.001); patients ≥ 10 years were more likely to develop chronic ITP than younger ones (p = 0.029). Regarding residency, seasonality, type of bleeding and history of preceding infection or vaccination, the difference was not statistically significant. Initial platelet counts > 20 × 109 were significantly more prevalent in chronic ITP (p < 0.001). LDH level at presentation was significantly higher in chronic cases (p = 0.046). Initial lines of treatment were the following: steroids, IVIG, and IVIG with steroids (in 88%, 5.2%, and 2.9% of the cases, respectively). A total of 3.9% of the children did not receive any treatment. There was no significant difference in the outcomes between the initial lines of treatment (p = 0.105). In our study, age > 10 years, female gender, higher platelet count and high LDH level at presentation were found to increase the probability of chronic ITP.

Об авторах

Aliaa Mohammed Diab
Benha University
Египет

Aliaa Mohammed Diab, Pediatric Department, Faculty of Medicine 

Benha 



AlRawhaa Ahmed Abouamer
Benha University
Египет

Benha



Ghada Saad Abdel Motaleb
Benha University
Египет

Benha



Khaled Abdelaziem Eid
Cairo University
Египет

Cairo



Heba Ismaiel Abdelnaiem
Benha University
Египет

Benha



Список литературы

1. Abadi U., Yarchovsky-Dolberg O., Ellis M.H. Immune thrombocytopenia: recent progress in pathophysiology and treatment. Clin Appl Thromb Hemost 2015;21 (5): 397–404.

2. Lanzkowsky P., ed. Manual of pediatric hematology and oncology. Elsevier; 2005 Jun. 4th ed; chapter 10, p: 250–9.

3. Imbach P., Kühne T., Müller D., Berchtold W., Zimmerman S., Elalfy M., et al. Childhood ITP: 12 months follow-up data from the prospective registry I of the Intercontinental Childhood ITP Study Group (ICIS). Pediatr Blood Cancer 2006; 46 (3): 351–6.

4. Rodeghiero F., Stasi R., Gernsheimer T., Michel M., Provan D., Arnold D.M., et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 2009; 113 (11): 2386–93.

5. Provan D., Stasi R., Newland A.C., Blanchette V.S., Bolton-Maggs P., Bussel J.B., et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood 2010; 115 (2): 168–86.

6. Burness C.B., Keating G.M., Garnock-Jones K.P. Eltrombopag: a review in paediatric chronic immune thrombocytopenia. Drugs 2016; 76 (8): 869–78.

7. Liang Y., Zhang L., Gao J., Hu D., Ai Y. Rituximab for children with immune thrombocytopenia: a systematic review. PloS One 2012; 7 (5): e36698.

8. Makis A., Gkoutsias A., Palianopoulos T., Pappa E., Papapetrou E., Tsaousi C., et al. Prognostic factors for immune thrombocytopenia outcome in Greek children: A retrospective single-centered analysis. Adv Hematol 2017; 2017: 7878605.

9. Yong M., Schoonen W.M., Li L., Kanas G., Coalson J., Mowat F., et al. Epidemiology of paediatric immune thrombocytopenia in the General Practice Research Database. Br J Haematol 2010; 149 (6): 855–64.

10. Saeidi S., Jaseb K., Asnafi A.A., Rahim F., Pourmotahari F., Mardaniyan S., et al. Immune thrombocytopenic purpura in children and adults: a comparative retrospective study in IRAN. Int J Hematol Oncology Stem Cell Res 2014; 8 (3): 30.

11. Nazari S.H., Abdollah G.F., Sadeghi K.M. Epidemiology of idiopathic thrombocytopenic purpura in children. Iran J Pediatric Hematol Oncol 2012; 2 (1): 35–9.

12. AL-Zuhairy S.H. Evaluation of prognostic factors in newly diagnosed childhood primary immune thrombocytopenia (ITP): two-year prospective study at Al-Sadder Hospital, Missan Province. Med J Babylon 2013; 10: 855–69.

13. France E.K., Glanz J., Xu S., Hambidge S., Yamasaki K., Black S.B., et al. Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children. Pediatrics 2008; 121 (3): e687–92.

14. Söğüt G., Leblebisatan G., Barutçu A., Kilinç Y., Şaşmaz H.İ. Evaluation of Pediatric Patients with Immune Thrombocytopenia Regarding Clinical Course and Treatment Response: A Retrospective Single-Center Experience. Pediatr Pract Res 2020; 8 (2): 38–42.

15. Al-Samkari H., Kuter D.J. Lactate dehydrogenase is elevated in immune thrombocytopenia and inversely correlates with platelet count. Br J Haematol 2019; 187 (3): e61–4.

16. Grimaldi-Bensouda L., Nordon C., Leblanc T., Abenhaim L., Allali S., Armari-Alla C., et al. Childhood immune thrombocytopenia: A nationwide cohort study on condition management and outcomes. Pediatr Blood Cancer 2017; 64 (7): e26389.

17. Singh G., Bansal D., Wright N.A. Immune thrombocytopenia in children: Consensus and controversies. Ind J Pediatr 2020; 87 (2): 150–7.

18. Güngör T., Bilir Ö.A., Çulha V.K., Güngör A., Kara A., Azık F.M., et al. Retrospective evaluation of children with immune thrombocytopenic purpura and factors contributing to chronicity. Pediatr Neonatol 2019; 60 (4): 411–6.

19. Donato H., Picón A., Martinez M., Rapetti M.C., Rosso A., Gomez S., et al. Demographic data, natural history, and prognostic factors of idiopathic thrombocytopenic purpura in children: a multicentered study from Argentina. Pediatr Blood Cancer 2009; 52 (4): 491–6.

20. Watts R.G. Idiopathic thrombocytopenic purpura: a 10-year natural history study at the childrens hospital of alabama. Clini Pediatr 2004; 43 (8): 691–702.

21. Bansal D., Bhamare T.A., Trehan A., Ahluwalia J., Varma N., Marwaha R.K. Outcome of chronic idiopathic thrombocytopenic purpura in children. Pediatr Blood Cancer 2010; 54 (3): 403–7.

22. Akbayram S., Dogan M., Ustyol L., Akgun C., Peker E., Bilici S., et al. The clinical outcome of 260 pediatric ITP patients in one center. Clin Appl Thromb Hemost 2011; 17 (6): е30–5.


Для цитирования:


Diab A.M., Abouamer A.A., Motaleb G.S., Eid K.A., Abdelnaiem H.I. Prognostic evaluation of immune thrombocytopenia outcomes in Egyptian children: a retrospective single-center experience. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2021;20(3):26-30. https://doi.org/10.24287/1726-1708-2021-20-3-26-30

For citation:


Diab A.M., Abouamer A.A., Motaleb G.S., Eid K.A., Abdelnaiem H.I. Prognostic evaluation of immune thrombocytopenia outcomes in Egyptian children: a retrospective single-center experience. Pediatric Hematology/Oncology and Immunopathology. 2021;20(3):26-30. https://doi.org/10.24287/1726-1708-2021-20-3-26-30

Просмотров: 153


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1726-1708 (Print)
ISSN 2414-9314 (Online)