Contributions
Abstract: PB1731
Type: Publication Only
Session title: Platelet disorders
Background
Immune thrombocytopenia (ITP) in adults is an auto-immune disease treated in first- line by corticosteroids and polyvalent immunoglobulins. This disease has frequently a chronic evolution. Risk factors for chronicity are not well defined and were explored in only a few studies.
Aims
The aims of this study were to report the clinical features of adult ITP, and to identify the clinical and biological risk factors predicting chronicity.
Methods
This was a monocentric retrospective study that collected data from adult patients followed for newly diagnosed ITP over a six year-period (2011 - 2017). Patients with platelets inferior to 30000/mm3 were initially treated with corticosteroids. Second-line treatment consisted of splenectomy or danazol. Thrombopoeitin receptor agonists were not available in Tunisia during the period of the study.
Results
One hundred and fifty patients were included, with a median age of 43 (16-79). The median platelet count was 15000/mm3 (0-88000). Response to corticosteroids was observed in 84,6% of patients with 71,5% of complete response. But recurrence of thrombocytopenia occurred in 27,2% of these patients .Chronic ITP was noted in 32,4%of patients, while newly diagnosed and persistent ITP were noted in 59,3% and 8,3% respectively.
Clinical and biological predictors of chronicity were studied. Clinical factors studied were: age, sex, the presence of bleeding symptoms,Khellaf score, the corticosteroid resistance, the time to response to corticosteroids, the duration between the response to corticosteroids and the recurrence of ITP. Biological factors studied were: the mean platelets count at baseline, the presence of antinuclear antibodies, the presence of antiphospholipid antibodies, the platelet-to-lymphocyte ratio at baseline (PLR). Only the presence of bleeding symptoms at diagnosis (p=0,033), the corticosteroid resistance (p=0,000) and the PLR <0.86 (p=0,031) were associated with a significant risk of progression to chronic ITP.
Conclusion
The progression to chronic ITP is frequent. The predictive markers of chronicity can be used to introduce promptly a second-line treatment and avoid prolonged courses of corticosteroids.
Keyword(s): Chronic ITP, Immune thrombocytopenia (ITP)
Abstract: PB1731
Type: Publication Only
Session title: Platelet disorders
Background
Immune thrombocytopenia (ITP) in adults is an auto-immune disease treated in first- line by corticosteroids and polyvalent immunoglobulins. This disease has frequently a chronic evolution. Risk factors for chronicity are not well defined and were explored in only a few studies.
Aims
The aims of this study were to report the clinical features of adult ITP, and to identify the clinical and biological risk factors predicting chronicity.
Methods
This was a monocentric retrospective study that collected data from adult patients followed for newly diagnosed ITP over a six year-period (2011 - 2017). Patients with platelets inferior to 30000/mm3 were initially treated with corticosteroids. Second-line treatment consisted of splenectomy or danazol. Thrombopoeitin receptor agonists were not available in Tunisia during the period of the study.
Results
One hundred and fifty patients were included, with a median age of 43 (16-79). The median platelet count was 15000/mm3 (0-88000). Response to corticosteroids was observed in 84,6% of patients with 71,5% of complete response. But recurrence of thrombocytopenia occurred in 27,2% of these patients .Chronic ITP was noted in 32,4%of patients, while newly diagnosed and persistent ITP were noted in 59,3% and 8,3% respectively.
Clinical and biological predictors of chronicity were studied. Clinical factors studied were: age, sex, the presence of bleeding symptoms,Khellaf score, the corticosteroid resistance, the time to response to corticosteroids, the duration between the response to corticosteroids and the recurrence of ITP. Biological factors studied were: the mean platelets count at baseline, the presence of antinuclear antibodies, the presence of antiphospholipid antibodies, the platelet-to-lymphocyte ratio at baseline (PLR). Only the presence of bleeding symptoms at diagnosis (p=0,033), the corticosteroid resistance (p=0,000) and the PLR <0.86 (p=0,031) were associated with a significant risk of progression to chronic ITP.
Conclusion
The progression to chronic ITP is frequent. The predictive markers of chronicity can be used to introduce promptly a second-line treatment and avoid prolonged courses of corticosteroids.
Keyword(s): Chronic ITP, Immune thrombocytopenia (ITP)