Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia

Data from the Intercontinental Cooperative ITP Study Group (ICIS)

Cindy E. Neunert, George R. Buchanan, Paul Imbach, Paula H B Bolton-Maggs, Carolyn M. Bennett, Ellis Neufeld, Sara K. Vesely, Leah Adix, Victor S. Blanchette, Thomas Kühne, Participants Intercontinental Cooperative ITP Study Group Registry

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Long-term follow-up of children with immune thrombocytopenia (ITP) indicates that the majority undergo remission and severe thrombocytopenia is infrequent. Details regarding bleeding manifestations, however, remain poorly categorized. We report here long-term data from the Intercontinental Cooperative ITP Study Group Registry II focusing on natural history, bleeding manifestations, and management. Data on 1345 subjects were collected at diagnosis and at 28 days, 6, 12, and 24 months thereafter. Median platelet counts were 214 3 109/L (interquartile range [IQR] 227, range 1-748), 211 3 109/L (IQR 192, range 1-594), and 215 3 109/L (IQR 198, range 1-598) at 6, 12, and 24 months, respectively, and a platelet count <20 3 109/L was uncommon (7%, 7%, and 4%, respectively). Remission occurred in 37% of patients between 28 days and 6 months, 16% between 6 and 12 months, and 24% between 12 and 24 months. There were no reports of intracranial hemorrhage, and the most common site of bleeding was skin. In patients with severe thrombocytopenia we observed a trend toward more drug treatment with increasing number of bleeding sites. Our data support that ITP is a benign condition for most affected children and that major hemorrhage, even with prolonged severe thrombocytopenia, is rare.

Original languageEnglish (US)
Pages (from-to)4457-4462
Number of pages6
JournalBlood
Volume121
Issue number22
DOIs
StatePublished - May 30 2013

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Idiopathic Thrombocytopenic Purpura
Platelets
Hemorrhage
Drug therapy
Thrombocytopenia
Skin
Platelet Count
Intracranial Hemorrhages
Natural History
Registries
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Neunert, C. E., Buchanan, G. R., Imbach, P., Bolton-Maggs, P. H. B., Bennett, C. M., Neufeld, E., ... Intercontinental Cooperative ITP Study Group Registry, P. (2013). Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: Data from the Intercontinental Cooperative ITP Study Group (ICIS). Blood, 121(22), 4457-4462. https://doi.org/10.1182/blood-2012-12-466375

Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia : Data from the Intercontinental Cooperative ITP Study Group (ICIS). / Neunert, Cindy E.; Buchanan, George R.; Imbach, Paul; Bolton-Maggs, Paula H B; Bennett, Carolyn M.; Neufeld, Ellis; Vesely, Sara K.; Adix, Leah; Blanchette, Victor S.; Kühne, Thomas; Intercontinental Cooperative ITP Study Group Registry, Participants.

In: Blood, Vol. 121, No. 22, 30.05.2013, p. 4457-4462.

Research output: Contribution to journalArticle

Neunert, CE, Buchanan, GR, Imbach, P, Bolton-Maggs, PHB, Bennett, CM, Neufeld, E, Vesely, SK, Adix, L, Blanchette, VS, Kühne, T & Intercontinental Cooperative ITP Study Group Registry, P 2013, 'Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: Data from the Intercontinental Cooperative ITP Study Group (ICIS)', Blood, vol. 121, no. 22, pp. 4457-4462. https://doi.org/10.1182/blood-2012-12-466375
Neunert, Cindy E. ; Buchanan, George R. ; Imbach, Paul ; Bolton-Maggs, Paula H B ; Bennett, Carolyn M. ; Neufeld, Ellis ; Vesely, Sara K. ; Adix, Leah ; Blanchette, Victor S. ; Kühne, Thomas ; Intercontinental Cooperative ITP Study Group Registry, Participants. / Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia : Data from the Intercontinental Cooperative ITP Study Group (ICIS). In: Blood. 2013 ; Vol. 121, No. 22. pp. 4457-4462.
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