Good Prognosis of Adult Immune Thrombocytopenia in a Provincial Hospital

Abstract

Objective: This study aimed to assess the clinical course and identify factors related to sustained responses to treatment among patients with immune thrombocytopenia (ITP). Methods: This observational retrospective cohort study of patients with ITP was conducted from January 2013 to December 2022 at Trang Hospital. Results: A total of 125 newly diagnosed patients with ITP were enrolled. The characteristics of the patients were as follows: age below 60 years (78.4%), female (75.2%), secondary ITP (32.8%), bleeding symptoms (54.4%), lost to follow-up (10.4%) and death (4%). The median platelet count at baseline was 6 x 10⁹ /L (range, 1-96 x 10⁹ /L) with 64% had platelet <10 x 10⁹/L. Platelet recovery time after treatment was 28 days (range, 0-730 days). The median response duration after the first line treatment especially corticosteroids was 14 months (range, 0-131 months). The clinical courses were as follows: recovery within 3 months in 68.8%, persistence in 13.6% and chronic ITP in 17.6%. The responses to corticosteroid treatment included early response (32.8%), initial response (47.5%) and durable response (69.6%). The responses to second-line treatments were early response (46.4%), initial response (42.9%) and durable response (92.8%). Only female sex (Adjusted Odds ratio, 3.5; 95% CI, 1.40-8.72) was significantly associated with the durable response to corticosteroids. Conclusion: This study reveals a favorable prognosis for ITP with the majority of patients showing a durable response. Female patients were more likely to respond.