Treatment outcomes of Children with Newly diagnosed Immune Thrombocytopenia in a Tertiary care Hospital

  • Bunchoo Pongtanakul
  • Yuttapon Titaram
  • Nassawee Vathana Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Nattee Narkbunnam Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Chayamon Takpradit Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Keywords: Immune thrombocytopenia, children, treatment


There are many clinical practice guidelines in newly diagnosed immune thrombocytopenia (nITP), treatment options are based on clinicians’ decision. The different treatment have different outcomes and complications. Objective: To evaluate treatment outcomes and the incidence of chronic ITP (cITP) among different treatments. Materials and Methods: We reviewed the patients’ medical records diagnosed with nITP aged 3 months to 15 years at Siriraj hospital between 2006-2010. Results: Ninety seven patients were treated in 5 different treatment strategies, observation (obs) 13.4%, prednisolone 2 mg/kg/day (P2) 24.8%, prednisolone 4 mg/kg/day (P4) 27.8%, pulse methylprednisolone (MP) 5.1% and intravenous immunoglobulin (IVIG) 28.8%. The median response time were in obs: 55, P2: 15, P4: 12, MP 12 and IVIG 3 days. In IVIG group was significantly faster than in obs and P2 (p = 0.002 and 0.01) and in P4 is significantly faster than obs (p = 0.03) but those between other groups were not significant. Sixty four patients completed 1 year follow up and 28.1% developed cITP: 71.4% in obs, 40% in P2, 26.3% in P4, 20% in MP, and 5.6% in IVIG group developed cITP. The patients with cITP in IVIG group is lower than in obs and P2 significantly (P = 0.002 and 0.03) but in between the other groups were not significant. Conclusion: The response time in IVIG group is faster than obs, P2 and P4. The incidence of cITP in IVIG is lower than in obs and P2 group. The results may be applied to treatment for each patients’ condition. 


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นิพนธ์ต้นฉบับ (Original article)