Jayabose Somasundaram, Levendoglu-Tugal Oya, Ozkaynkak Mehmet F, Visintainer Paul, Sandoval Claudio
Department of Pediatrics, New York Medical College, Valhalla, New York, USA.
J Pediatr Hematol Oncol. 2004 Nov;26(11):724-6. doi: 10.1097/00043426-200411000-00007.
Children with chronic idiopathic thrombocytopenic purpura (ITP) generally have a favorable outcome, but it is not known whether there are any prognostic factors to predict outcome. The objectives of this study were to assess the spontaneous remission rate and the prognostic significance of age, gender, initial platelet count, initial treatment, and response to treatment.
In this retrospective review of 62 consecutive children with chronic ITP, 37 were girls and 27 were 10 years of age or older (median age 9 years; range, 0.75-19).
Thirty-five patients (56%) achieved spontaneous remission (remission without splenectomy), 30 of them (48%) within 4 years from diagnosis. Twenty-eight (45%) were complete remissions (platelet counts of >/=100,000) and 7 (11%) were partial remissions (50,000-99,000). There was no significant difference in the spontaneous remission rate between the younger (<10 years) and older children (55.8% vs. 57.1%, P = 0.95) or between boys and girls (56% vs. 56.7%, P = 0.98). Similarly, platelet count at initial diagnosis, initial therapy, or response to initial therapy did not have any prognostic significance. All 14 patients who underwent splenectomy achieved complete remission.
More than 50% of children with chronic ITP achieve spontaneous remission. Age, gender, platelet count at initial diagnosis, initial treatment, and response to initial treatment do not have any prognostic significance toward the outcome of chronic ITP.
慢性特发性血小板减少性紫癜（ITP）患儿通常预后良好，但尚不清楚是否存在预测预后的因素。本研究的目的是评估自发缓解率以及年龄、性别、初始血小板计数、初始治疗和治疗反应的预后意义。
在这项对62例连续性慢性ITP患儿的回顾性研究中，37例为女孩，27例年龄在10岁及以上（中位年龄9岁；范围0.75 - 19岁）。
35例患者（56%）实现自发缓解（未行脾切除术而缓解），其中30例（48%）在诊断后4年内缓解。28例（45%）为完全缓解（血小板计数≥100,000），7例（11%）为部分缓解（50,000 - 99,000）。年龄较小（<10岁）和较大儿童之间的自发缓解率无显著差异（55.8%对57.1%，P = 0.95），男孩和女孩之间也无显著差异（56%对56.7%，P = 0.98）。同样，初始诊断时的血小板计数、初始治疗或对初始治疗的反应均无预后意义。所有14例行脾切除术的患者均实现完全缓解。
超过50%的慢性ITP患儿实现自发缓解。年龄、性别、初始诊断时的血小板计数、初始治疗和对初始治疗的反应对慢性ITP的预后均无预后意义。
