SEARCH:   Advanced

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Portielje, J. E. A. Articles by Brand, A. Search for Related Content PubMed PubMed Citation Articles by Portielje, J. E. A. Articles by Brand, A. Related Collections Clinical Trials and Observations Related Letters in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 May 2001, Vol. 97, No. 9, pp. 2549-2554 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Morbidity and mortality in adults with idiopathic thrombocytopenic purpura Johanna E. A. Portielje, Rudi G. J. Westendorp, Hanneke C. Kluin-Nelemans, and Anneke Brand From the Departments of Internal Medicine, Clinical Epidemiology, and Hematology, Leiden University Medical Center, The Netherlands. To study outcomes of adults with idiopathic thrombocytopenic purpura (ITP), we performed a follow-up study in a cohort of 152 consecutive patients who were treated according to a well-defined algorithm. Long-term outcomes were determined relative to the response 2 years after diagnosis, because most (93%) patients who ultimately attained platelet counts above 30.0 × 109/L (30 000/µL) did so within this time frame. Complete follow-up for mortality could be studied in 99% of patients and for morbidity in 95% of patients, with a mean of 10.5 years. Within 2 years after diagnosis, 4 patients died, 2 were lost to follow-up, and 12 were reclassified as having secondary immune thrombocytopenia. Of the remaining 134 patients, 114 (85%) had obtained platelet counts above 30.0 × 109/L while all therapies had been discontinued. These patients had a long-term mortality risk equal to the general population. Twelve of 134 patients (9%), all with severe thrombocytopenia, had refractory disease and suffered a mortality risk of 4.2 (95% confidence interval, 1.7-10.0). Bleeding and infection equally contributed to the death of these patients. Another 8 patients (6%) had platelet counts above 30.0 × 109/L while on maintenance therapy. Similar to patients with refractory disease, these latter patients had considerably increased ITP-related hospital admissions, but mortality was only slightly higher than in the general population. In conclusion, most adults with ITP have a good outcome with infrequent hospital admissions and no excess mortality. The absence of gross morbidity and mortality in patients with moderate thrombocytopenia supports clinical practice refraining from further treatment. © 2001 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letters in Blood Online: The natural history of refractory idiopathic thrombocytopenic purpura Benjamin Djulbegovic, Yael Cohen, Johanna E. A. Portielje, Rudi G. J. Westendorp, Hanneke C. Kluin-Nelemans, and Anneke Brand Blood 2001 98: 2282-2283. [Full Text] [PDF] Short-course corticosteroid-induced pulmonary and apparent cerebral aspergillosis in a patient with idiopathic thrombocytopenic purpura John Apostolidis, Marina Tsandekidi, Demitris Kousiafes, Maria Pagoni, Chrisanthi Mitsouli, Themis Karmiris, Maria Bakiri, Demitris Karakasis, Nikolaos Harhalakis, and Emmanuel Nikiforakis Blood 2001 98: 2875-2877. [Full Text] [PDF] This article has been cited by other articles: J. N. George Definition, diagnosis and treatment of immune thrombocytopenic purpura Haematologica, June 1, 2009; 94(6): 759 - 762. [Full Text] [PDF] J. Burzynski New options after first-line therapy for chronic immune thrombocytopenic purpura Am. J. Health Syst. Pharm., January 15, 2009; 66(2_Supplement_2): S11 - S21. [Abstract] [Full Text] [PDF] B. Godeau, R. Porcher, O. Fain, F. Lefrere, P. Fenaux, S. Cheze, A. Vekhoff, M.-P. Chauveheid, J. Stirnemann, L. Galicier, et al. Rituximab efficacy and safety in adult splenectomy candidates with chronic immune thrombocytopenic purpura: results of a prospective multicenter phase 2 study Blood, August 15, 2008; 112(4): 999 - 1004. [Abstract] [Full Text] [PDF] C. Visco, M. Ruggeri, M. Laura Evangelista, R. Stasi, R. Zanotti, I. Giaretta, A. Ambrosetti, D. Madeo, G. Pizzolo, and F. Rodeghiero Impact of immune thrombocytopenia on the clinical course of chronic lymphocytic leukemia Blood, February 1, 2008; 111(3): 1110 - 1116. [Abstract] [Full Text] [PDF] M. Ruggeri, S. Fortuna, and F. Rodeghiero Heterogeneity of terminology and clinical definitions in adult idiopathic thrombocytopenic purpura: a critical appraisal from a systematic review of the literature Haematologica, January 1, 2008; 93(1): 98 - 103. [Abstract] [Full Text] [PDF] T. B. Gernsheimer The Pathophysiology of ITP Revisited: Ineffective Thrombopoiesis and the Emerging Role of Thrombopoietin Receptor Agonists in the Management of Chronic Immune Thrombocytopenic Purpura Hematology, January 1, 2008; 2008(1): 219 - 226. [Abstract] [Full Text] [PDF] D. Provan, T. Butler, M. L. Evangelista, S. Amadori, A. C. Newland, and R. Stasi Activity and safety profile of low-dose rituximab for the treatment of autoimmune cytopenias in adults Haematologica, December 1, 2007; 92(12): 1695 - 1698. [Abstract] [Full Text] [PDF] D. M. Boruchov, S. Gururangan, M. C. Driscoll, and J. B. Bussel Multiagent induction and maintenance therapy for patients with refractory immune thrombocytopenic purpura (ITP) Blood, November 15, 2007; 110(10): 3526 - 3531. [Abstract] [Full Text] [PDF] M. G. Mazzucconi, P. Fazi, S. Bernasconi, G. De Rossi, G. Leone, L. Gugliotta, N. Vianelli, G. Avvisati, F. Rodeghiero, A. Amendola, et al. Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura: a GIMEMA experience Blood, February 15, 2007; 109(4): 1401 - 1407. [Abstract] [Full Text] [PDF] D. M. Arnold, F. Dentali, M. A. Crowther, R. M. Meyer, R. J. Cook, C. Sigouin, G. A. Fraser, W. Lim, and J. G. Kelton Systematic Review: Efficacy and Safety of Rituximab for Adults with Idiopathic Thrombocytopenic Purpura Ann Intern Med, January 2, 2007; 146(1): 25 - 33. [Abstract] [Full Text] [PDF] E. Elli, M. Parma, P. Perseghin, M. Dassi, E. Terruzzi, D. Belotti, P. Pioltelli, and E.M. Pogliani Successful treatment with T depleted autologous peripheral blood stem cell transplantation of refractory chronic autoimmune thrombocytopenic purpura Haematologica, January 1, 2007; 92(1): e7 - e8. [Abstract] [Full Text] [PDF] M. A. Crowther and T. C. Abshire Hemostasis and thrombosis ASH Self-Assessment Program, January 1, 2007; 2007(1): 361 - 407. [Full Text] [PDF] W S A Smellie, J Forth, D Bareford, P Twomey, M J Galloway, E C M Logan, S R S Smart, T M Reynolds, and C Waine Best practice in primary care pathology: review 3. J. Clin. Pathol., August 1, 2006; 59(8): 781 - 789. [Abstract] [Full Text] [PDF] D. S. Beardsley ITP in the 21st Century Hematology, January 1, 2006; 2006(1): 402 - 407. [Abstract] [Full Text] [PDF] D. B. Cines and J. B. Bussel How I treat idiopathic thrombocytopenic purpura (ITP) Blood, October 1, 2005; 106(7): 2244 - 2251. [Full Text] [PDF] K. Kojouri, S. K. Vesely, D. R. Terrell, and J. N. George Splenectomy for adult patients with idiopathic thrombocytopenic purpura: a systematic review to assess long-term platelet count responses, prediction of response, and surgical complications Blood, November 1, 2004; 104(9): 2623 - 2634. [Abstract] [Full Text] [PDF] R. McMillan and C. Durette Long-term outcomes in adults with chronic ITP after splenectomy failure Blood, August 15, 2004; 104(4): 956 - 960. [Abstract] [Full Text] [PDF] F. Fabris, R. Scandellari, E. Ruzzon, M. L. Randi, G. Luzzatto, and A. Girolami Platelet-associated autoantibodies as detected by a solid-phase modified antigen capture ELISA test (MACE) are a useful prognostic factor in idiopathic thrombocytopenic purpura Blood, June 15, 2004; 103(12): 4562 - 4564. [Abstract] [Full Text] [PDF] R. Stasi and D. Provan Management of Immune Thrombocytopenic Purpura in Adults Mayo Clin. Proc., April 1, 2004; 79(4): 504 - 522. [Abstract] [PDF] S. K. Vesely, J. J. Perdue, M. A. Rizvi, D. R. Terrell, and J. N. George Management of Adult Patients with Persistent Idiopathic Thrombocytopenic Purpura Following Splenectomy: A Systematic Review Ann Intern Med, January 20, 2004; 140(2): 112 - 120. [Abstract] [Full Text] [PDF] Y. Cheng, R. S.M. Wong, Y. O.Y. Soo, C. H. Chui, F. Y. Lau, N. P.H. Chan, W. S. Wong, and G. Cheng Initial Treatment of Immune Thrombocytopenic Purpura with High-Dose Dexamethasone N. Engl. J. Med., August 28, 2003; 349(9): 831 - 836. [Abstract] [Full Text] [PDF] J. N. George and S. K. Vesely Immune Thrombocytopenic Purpura -- Let the Treatment Fit the Patient N. Engl. J. Med., August 28, 2003; 349(9): 903 - 905. [Full Text] [PDF] R. D. Huhn, P. F. Fogarty, R. Nakamura, E. J. Read, S. F. Leitman, M. E. Rick, J. Kimball, A. Greene, K. Hansmann, A. Gratwohl, et al. High-dose cyclophosphamide with autologous lymphocyte-depleted peripheral blood stem cell (PBSC) support for treatment of refractory chronic autoimmune thrombocytopenia Blood, January 1, 2003; 101(1): 71 - 77. [Abstract] [Full Text] [PDF] D. B. Cines and V. S. Blanchette Immune Thrombocytopenic Purpura N. Engl. J. Med., March 28, 2002; 346(13): 995 - 1008. [Full Text] [PDF] N. Cooper, B. M. R. Woloski, E. M. Fodero, M. Novoa, M. Leber, J. H. Beer, and J. B. Bussel Does treatment with intermittent infusions of intravenous anti-D allow a proportion of adults with recently diagnosed immune thrombocytopenic purpura to avoid splenectomy? Blood, March 15, 2002; 99(6): 1922 - 1927. [Abstract] [Full Text] [PDF] G. Emilia, M. Morselli, M. Luppi, G. Longo, R. Marasca, G. Gandini, L. Ferrara, N. D'Apollo, L. Potenza, M. Bertesi, et al. Long-term salvage therapy with cyclosporin A in refractory idiopathic thrombocytopenic purpura Blood, February 15, 2002; 99(4): 1482 - 1485. [Abstract] [Full Text] [PDF] J. Apostolidis, M. Tsandekidi, D. Kousiafes, M. Pagoni, C. Mitsouli, T. Karmiris, M. Bakiri, D. Karakasis, N. Harhalakis, and E. Nikiforakis Short-course corticosteroid-induced pulmonary and apparent cerebral aspergillosis in a patient with idiopathic thrombocytopenic purpura Blood, November 1, 2001; 98(9): 2875 - 2877. [Full Text] [PDF] B. Djulbegovic, Y. Cohen, J. E. A. Portielje, R. G. J. Westendorp, H. C. Kluin-Nelemans, and A. Brand The natural history of refractory idiopathic thrombocytopenic purpura Blood, October 1, 2001; 98(7): 2282 - 2283. [Full Text] [PDF] K. R. McCrae, J. B. Bussel, P. M. Mannucci, G. Remuzzi, and D. B. Cines Platelets: An Update on Diagnosis and Management of Thrombocytopenic Disorders Hematology, January 1, 2001; 2001(1): 282 - 305. [Abstract] [Full Text] [PDF]

	Copyright © 2001 by American Society of Hematology         Online ISSN: 1528-0020