Pediatric Hematology and Oncology, Hospital Infantil Universitario Niño Jesús, 28009, Madrid, Spain.
Fundación para la investigación Biomédica HIUNJ, Hospital Infantil Universitario Niño Jesús, 28009, Madrid, Spain.
Eur J Pediatr. 2021 Jul;180(7):2075-2081. doi: 10.1007/s00431-021-03990-8. Epub 2021 Feb 16.
Classically, several variables have been related to the disease course of chronic primary immune thrombocytopenia (cITP), though to date, there is no consensus on their clinical relevance. In a recent systematic review, a meta-analysis was made and confirmed the existence of certain cITP-related variables that may be related to prognosis in pediatric patients. We retrospectively analyzed a cohort of patients diagnosed with ITP, identified prognostic variables, and compared our results to the variables described by the authors. A multivariate study revealed that older age at diagnosis and higher platelet count were the only independent variables related to cITP. Children up to age 4 years and those with lower platelet counts (below 20 × 10/L) were at lower risk for cITP.Conclusion: We therefore concluded that only age and platelet count at diagnosis are independent variables that should be considered when evaluating the risk of developing cITP. What is Known: • Around 20% of patients with immune thrombocytopenia progress to chronic disease as determined by a sustained platelet count below 100×10/L for more than 12 months. • A number of variables potentially related to the development of cITP are being studied, such as age, sex, cell count, and previous treatment. What is New: • This is a new group of patients diagnosed with ITP in which the platelet count and age at diagnosis are the only independent variables closely related to cITP. • In this new series, we could not confirm other variables previously related to cITP such as total leukocyte count or the absence of treatment at diagnosis.
经典地，有几个变量与慢性原发性免疫性血小板减少症（cITP）的疾病过程有关，但迄今为止，它们的临床相关性尚无共识。在最近的系统评价中，进行了一项荟萃分析，证实了某些与 cITP 相关的变量的存在，这些变量可能与儿科患者的预后有关。我们回顾性地分析了一组诊断为 ITP 的患者，确定了预后变量，并将我们的结果与作者描述的变量进行了比较。多变量研究表明，诊断时年龄较大和血小板计数较高是与 cITP 相关的唯一独立变量。年龄在 4 岁以下和血小板计数较低（低于 20×10/L）的儿童发生 cITP 的风险较低。结论：因此，我们得出结论，只有诊断时的年龄和血小板计数是评估发生 cITP 风险时应考虑的独立变量。已知的：•大约 20%的免疫性血小板减少症患者会发展为慢性疾病，其特征是血小板计数持续低于 100×10/L 超过 12 个月。•正在研究许多与 cITP 发展相关的潜在变量，例如年龄、性别、细胞计数和先前的治疗。新的：•这是一组新诊断为 ITP 的患者，其中血小板计数和诊断时的年龄是与 cITP 密切相关的唯一独立变量。•在这个新系列中，我们无法证实以前与 cITP 相关的其他变量，例如总白细胞计数或诊断时无治疗。
