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A prospective comparative study of 2540 infants and children with newly diagnosed idiopathic thrombocytopenic purpura (ITP) from the intercontinental childhood ITP study group

  • Thomas Kühne
    Correspondence
    Reprint requests: Thomas Kühne, MD, Division of Oncology/Hematology, University Children's Hospital, Postfach, Römergasse 8, CH-4005 Basel, Switzerland.
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • George R Buchanan
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Sherri Zimmerman
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Lisa A Michaels
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Regina Kohan
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Willi Berchtold
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Paul Imbach
    Affiliations
    From the Divisions of Oncology/Hematology, University Children's Hospital, Basel, and the University of Applied Sciences of Aargau, Brugge, Switzerland; the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Duke University Medical Center, Durham, North Carolina; the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
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  • Author Footnotes
    ∗ All participating investigators and institutions are acknowledged at www.unibas.ch/itpbasel.

      Abstract

      Objective

      To analyze prospectively the impact of age at diagnosis in childhood idiopathic thrombocytopenic purpura (ITP).

      Study design

      International registry from June 1997 to May 2001, with analysis of data from baseline and 6-month-follow-up questionnaires.

      Results

      Data from 2540 patients were analyzed, including 203 infants (7.6%), 1860 children ≥1 to <10 years of age (69.1%), and 477 children and adolescents between ≥10 and <16 years of age (17.7%). The mean platelet count at diagnosis was similar in all three groups, as was the percentage of patients with initial platelet count <20×109/L. The male/female ratio was highest in infants and decreased with age (P = .009). Immunoglobulin therapy was used more often in infants and corticosteroids in patients ≥10 years of age. Follow-up information at 6 months was available for 1742 children (68.6%). Chronic ITP was seen less frequently in infants (23.1%) than in children >10 years of age (47.3%, P<.0001). Intracranial hemorrhage occurred in 3 of 1742 children during the first 6 months after the diagnosis of ITP.

      Conclusions

      Pediatric patients with ITP from infancy to adolescence exhibit heterogeneity in clinical, demographic, and treatment factors.

      Abbreviations:

      ICH (Intracranial hemorrhage), ICIS (Intercontinental Childhood ITP Study Group), ITP (Idiopathic thrombocytopenic purpura), IVIG (Intravenous immunoglobulin)
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