Primary immune thrombocytopenia in children according to contemporary definitions

Abstract

Background

Primary immune thrombocytopenia (ITP) is one of the most common hematologic disorders in pediatric population. In 2009 the new unified terminology regarding: definition, clinical classification of the disease and response to treatment was proposed. The main study objective was the comparative analysis of clinical aspects of primary ITP in children regarding the contemporary definitions and historical criteria.

Methods

Data were collected through medical chart review of subjects identified from hospitalization records (Pediatrics, Hematology and Oncology Department) from the period of 2002–2011.

Results

Data of 209 subjects were analyzed. According to recent definitions 206/209 patients (98.6%) could be defined. Using the historical criteria 86.12% were classified as acute and 13.88% as chronic ITP. Newly diagnosed primary immune thrombocytopenia was confirmed in 166/206 cases, persistent ITP in 20/206, and chronic ITP in 20/206 of subjects. Depending on applied criteria we noticed significant differences in acute ITP patient number. Regardless of adjusted definitions, the response rates were higher among treated patients (p<0.0001). Historical criteria allowed to recognize lower response rate in patients treated with intravenous immunoglobulins (p=0.009) or steroids (p=0.033).

Conclusions

Contemporary definitions allow for more adequate categorization on most of the patients with primary immune thrombocytopenia considering the specific clinical aspects and different natural history of primary ITP in children.