Patient selection: adult
Criteria for ITP:
(1) platelet count < 100,000 per µL
(2) normal or increased megakaryocytes on bone marrow examination
(3) absence of a clinically apparent cause for thrombocytopenia, including medications
Moderate thrombocytopenia was defined as a platelet count from 30,000 to 100,000 per µL without a count below 30,000 per µL during the first 3 months. Severe thrombocytopenia was defined as a platelet count below 30,000 per µL at any time during the first 3 months.
Parameters affecting outcome:
(1) platelet count at 2 years after diagnosis
(2) need for maintenance therapy
(3) identification of a secondary cause
If a secondary cause for the thromboctyopenia was identified then the relative risk for mortality was 6.0
For patients with ITP:
|
Platelet Count
|
Therapy
|
Mortality
|
|
> 30,000 per µL
|
discontinued
|
similar to general population
|
|
> 30,000 per µL
|
receiving ongoing maintenance therapy
|
increased hospital admissions; mortality only slightly increased
|
|
<= 30,000 per µL (refractory)
|
receiving maintenance therapy
|
increased hospital admissions and increased mortality
|
Causes of death in refractory patients:
(1) infection
(2) bleeding
