Management strategies for newly diagnosed immune thrombocytopenia in Italian AIEOP Centres: do we overtreat? Data from a multicentre, prospective cohort study

Autor:	Parodi, Emilia, Russo, Giovanna, Farruggia, Piero, Notarangelo, Lucia D., Giraudo, Maria T., Nardi, Margherita, Giona, Fiorina, Giordano, Paola, Ramenghi, Ugo, Barone, Angelica, Boscarol, Gianluca, Cesaro, Simone, Fioredda, Francesca, Ladogana, Saverio, Licciardello, Maria, Rossi, Francesca, Rubert, Laura, Spinelli, Marco, Tucci, Fabio
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Male p< 56 patients had chronic ITP which was significantly associated with younger age. Chronicity at 12 months was not affected by different therapeutic approaches at diagnosis or response to therapy thrombocytopenia 0.001) . At 1 year 95% confidence interval: 1.09-2.98). In total Background - The aim of the present study was to assess management strategies for immune thrombocytopenia (ITP) among Italian paediatric haematologists and to compare these with those of recent international guidelines. Predictors of early remission or disease chronicity were also evaluated. Materials and methods - During a period of 1 year 205 children (age: 1 month-18 years) with newly diagnosed ITP were prospectively enrolled by 16 centres belonging to the Italian Association of Paediatric Haematology and Oncology (AIEOP). We collected the subjects demographic data history clinical symptoms platelet count and treatment at presentation and at subsequent visits. Results - Of the 205 patients 47 (23%) were initially managed with a wait-and-see approach. Compared to these patients children administered platelet-enhancing therapies were significantly younger (median age: 4.75 vs 7.96 years p<0.001) and had lower platelet counts. At the 3-month follow-up 92/202 patients (46%) had persistent ITP. Recovery within 3 months was predicted by younger median age (5.3 vs 7.8 years p<0.001) and recent viral infection (p<0.001) . At 1 year 56 patients had chronic ITP which was associated with older median age (7.54 vs 5.35 years p<0.001) and a family history of autoimmunity (p<0.05 relative risk: 1.81 95% confidence interval: 1.09-2.98). In total 357 pharmacological treatments were recorded (216 intravenous immunoglobulins 80 steroids). Response to intravenous immunoglobulins did not have an effect on remission rate at 12 months. Discussion - Pediatric hematologists in Italian Centre treat over three-quarters of patients with newly diagnosed ITP despite recent international guidelines. Almost 80% of patients with mild clinical symptoms received pharmacological treatment at diagnosis which was significantly associated with younger age. Chronicity at 12 months was not affected by different therapeutic approaches at diagnosis or response to therapy Prospective Studies Child Children clinical symptoms which was associated with older median age (7.54 vs 5.35 years treatment Background - The aim of the present study was to assess management strategies for immune thrombocytopenia (ITP) among Italian paediatric haematologists Immunoglobulins Intravenous Italy 80 steroids). Response to intravenous immunoglobulins did not have an effect on remission rate at 12 months. Discussion - Pediatric hematologists in Italian Centre treat over three-quarters of patients with newly diagnosed ITP Child Preschool Practice Guidelines as Topic Female Steroids Guideline Adherence history thrombocytopenia pediatric treatment and to compare these with those of recent international guidelines. Predictors of early remission or disease chronicity were also evaluated. Materials and methods - During a period of 1 year 0.001) Adolescent platelet count and treatment at presentation and at subsequent visits. Results - Of the 205 patients 205 children (age: 1 month-18 years) with newly diagnosed ITP were prospectively enrolled by 16 centres belonging to the Italian Association of Paediatric Haematology and Oncology (AIEOP). We collected the subjects demographic data despite recent international guidelines. Almost 80% of patients with mild clinical symptoms received pharmacological treatment at diagnosis Humans IVIG Purpura Thrombocytopenic Idiopathic Platelet Count 0.05 357 pharmacological treatments were recorded (216 intravenous immunoglobulins Immune thrombocytopenia ITP Infant 47 (23%) were initially managed with a wait-and-see approach. Compared to these patients 92/202 patients (46%) had persistent ITP. Recovery within 3 months was predicted by younger median age (5.3 vs 7.8 years and recent viral infection (p< pediatric Others and a family history of autoimmunity (p< 0.001) and had lower platelet counts. At the 3-month follow-up Follow-Up Studies children administered platelet-enhancing therapies were significantly younger (median age: 4.75 vs 7.96 years
Zdroj:	Blood Transfus
Popis:	BACKGROUND: The aim of the present study was to assess management strategies for immune thrombocytopenia (ITP) among Italian paediatric haematologists, and to compare these with those of recent international guidelines. Predictors of early remission or disease chronicity were also evaluated. MATERIALS AND METHODS: During a period of 1 year, 205 children (age: 1 month-18 years) with newly diagnosed ITP were prospectively enrolled by 16 centres belonging to the Italian Association of Paediatric Haematology and Oncology (AIEOP). We collected the subjects demographic data, history, clinical symptoms, platelet count and treatment at presentation and at subsequent visits. RESULTS: Of the 205 patients, 47 (23%) were initially managed with a wait-and-see approach. Compared to these patients, children administered platelet-enhancing therapies were significantly younger (median age: 4.75 vs 7.96 years; p
Databáze:	OpenAIRE
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