Long-term follow-up of idiopathic thrombocytopenic purpura in 310 patients

• Published in: Haematologica (Roma) 2001-05, Vol.86 (5), p.504-509
• Main Authors: Vianelli, N, Valdre, L, Fiacchini, M, de Vivo, A, Gugliotta, L, Catani, L, Lemoli, RM, Poli, M, Tura, S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Female; Follow-Up Studies; Hematologic and hematopoietic diseases; Hemorrhage - etiology; Humans; Male; Medical sciences; Middle Aged; Platelet diseases and coagulopathies; Prognosis; Purpura, Thrombocytopenic, Idiopathic - complications; Purpura, Thrombocytopenic, Idiopathic - diagnosis; Purpura, Thrombocytopenic, Idiopathic - mortality; Retrospective Studies; Risk Factors
• ISSN: 0390-6078; 1592-8721

Istituto di Ematologia e Oncologia Medica Seragnoli, Policlinico S. Orsola, via Massarenti 9, 40138 Bologna, Italy. [e-mail] BACKGROUND AND OBJECTIVES. Idiopathic thrombocytopenic purpura (ITP) induces thrombocytopenia by means of an autoimmune mechanism. Despite the available therapies a subset of patients develop chronic refractory severe thrombocytopenia (i.e. a platelet count consistently lower than 20 to 30x10(9)/L), and life-threatening bleeding can occasionally occur. It has been suggested that the risk of major bleeding is higher in elderly patients and in patients with bleeding at diagnosis. However, since clear data on the influence of clinical and/or laboratory parameters on outcome are lacking, some patients may be receiving unnecessary treatment. DESIGN AND METHODS. We made a retrospective analysis of a series of 310 patients with chronic ITP (108 males and 202 females), with a median age at diagnosis of 40 years (range 8-87 years). The median follow-up time was 121 months, (range 7-434 months). Therapy was most often started in the presence of hemorrhagic complications and/or a platelet count 60 years was not associated with any significant differences in incidence of bleeding at diagnosis or during follow-up. INTERPRETATION AND CONCLUSIONS. We conclude that prospective studies are required to evaluate whether it may be reasonable to treat only symptomatic patients, independently of age.