Childhood Chronic Immune Thrombocytopenia: How Benign?

Clinicians who manage children with primary immune thrombocytopenia (ITP) and persistently low platelet counts face a daunting challenge. They must consider the possibility of spontaneous and trauma-associated hemorrhage in these patients. But how likely is serious bleeding in this setting?

To find out, investigators analyzed registry data from 1239 children (mean age, 5.3 years) with primary ITP, 343 of whom had platelet counts recorded at 6, 12, and 24 months after diagnosis. Durable remissions (platelet counts ≥150×10⁹/L) were recorded in 37% of patients between 28 days and 6 months, in 16% between 6 and 12 months, and in 24% between 12 and 24 months. At 24 months, 20% still had platelet counts <100×10⁹/L. Despite the persistence of throm…