Yang Ximei, Wan Xianghui, Huang Chao, Fu Jingjing, Hu Xiaolu, Le Ping, Ke Jiangwei
Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University.
Jiangxi Provincial Cancer Hospital, Nanchang, China.
J Pediatr Hematol Oncol. 2023 Mar 1;45(2):e254-e258. doi: 10.1097/MPH.0000000000002508. Epub 2022 Aug 3.
To re-evaluate the prognostic value of absolute lymphocyte count (ALC) in pediatric immune thrombocytopenia (ITP) from the perspective of age. A total of 242 ITP pediatric patients, including 141 newly diagnosed ITP (nITP), 89 chronic ITP (cITP), and 12 persistent ITP, were retrospectively reviewed for this study. These patients were divided into 3 groups according to age (group 1, ≤24 m; group 2, 24-72 m; and group 3, >72 m). The ALC detected at admission was significantly different between nITP and cITP patients without considering their age difference (5.22 vs. 3.55×10 9 /L, P <0.001). However, no significant difference was discovered after age stratification (≤24 m: 6.52 vs. 5.34×10 9 /L, P =0.161; 24-72 m: 3.78 vs. 3.63×10 9 /L, P =0.748; > 72 m: 2.53 vs. 2.40×10 9 /L, P =0.748). ROC analysis showed that the prognostic value of ALC in ITP children was limited (area under curve (AUC): ≤24 m, 24-72 m, and >72 m were 0.591, 0.570, and 0.542, respectively). Analysis of covariance showed there was no significant difference in ALC between nITP and cITP when considering age as a covariate ( P =0.131). Instead, the ROC showing that platelet to lymphocyte ratio (PLR) has prognostic value in pediatric ITP independent of age stratification (≤24 m: AUC, 0.688; 24-72 m: AUC, 0.741; >72 m: AUC, 0.680). In conclusion, there was no significant difference of ALC between nITP and cITP patients when stratified by different age groups, and PLR may be an optional prognostic indicator for ITP.
从年龄角度重新评估绝对淋巴细胞计数（ALC）在儿童免疫性血小板减少症（ITP）中的预后价值。本研究回顾性分析了242例ITP患儿，包括141例新诊断ITP（nITP）、89例慢性ITP（cITP）和12例持续性ITP。根据年龄将这些患者分为3组（1组，≤24个月；2组，24 - 72个月；3组，>72个月）。在不考虑年龄差异的情况下，nITP和cITP患者入院时检测的ALC有显著差异（5.22对3.55×10⁹/L，P<0.001）。然而，年龄分层后未发现显著差异（≤24个月：6.52对5.34×10⁹/L，P = 0.161；24 - 72个月：3.78对3.63×10⁹/L，P = 0.748；>72个月：2.53对2.40×10⁹/L，P = 0.748）。ROC分析显示，ALC在ITP儿童中的预后价值有限（曲线下面积（AUC）：≤24个月、24 - 72个月和>72个月分别为0.591、0.570和0.542）。协方差分析显示，将年龄作为协变量时，nITP和cITP之间的ALC无显著差异（P = 0.131）。相反，ROC显示血小板与淋巴细胞比值（PLR）在儿童ITP中具有独立于年龄分层的预后价值（≤24个月：AUC，0.688；24 - 72个月：AUC，0.741；>72个月：AUC，0.680）。总之，按不同年龄组分层时，nITP和cITP患者的ALC无显著差异，PLR可能是ITP的一个可选预后指标。
