PB0261 - Prediction of Favorable Outcome and Quality of Life of Children Diagnosed with Immune Thrombocytopenia

Background: Immune thrombocytopenia (ITP) is one of the common acquired bleeding disorders in children with age group 1–7 years and no difference in gender. ITP patients usually present with mucocutaneous bleeding. In patients with significant bleeding, treatment with IVIG, prednisolone, or anti-D is recommended. The remission rates are around 70% in acute ITP, and 30% in chronic ITP. Patients with chronic ITP may experience bleeding problems as well as medication side effects that could impair their quality of life (QoL).

Aims: To study the factors associated with outcome and QoL of children with ITP.

Methods: A retrospective study included children aged ≤18 years who were diagnosed with ITP during 2011-2022. Compiled data comprised demographic data, BMI-Z scores, platelet counts at diagnosis, and treatments. Pediatric QoL Questionnaire was used to measure QoL.

Results: A total of 88 patients, female: male 1.04:1, median age 3.7 (range 0-13.0) years, were enrolled. Median platelet count at diagnosis was 12.8 (range 0–86) x 109/L. Treatments included steroids (46.6%), IVIG (42%), and steroids with IVIG (4.5%). The median time of follow-up was 3.1 (range 0-16.7) years with a remission rate of 61.4% (70% remission at 12 months, 30% remission afterward). The median time of remission was 2.2 (range 0-4.5) months. IVIG treatment associated with shorter remission time when compared to steroids (Figure 1). Female patients had an Odds ratio of 3.0 (range 1.2–7.5), P= 0.017 in developing chronic ITP. PedQoL-patient showed a negative correlation to the platelet counts in the emotional aspect (r= -0.478, P= 0.28), whereas PedQoL-parent showed a negative correlation in the social aspect (r= -.565; P= 0.018).

Conclusion(s): Female patients are associated with chronic ITP. Patients with low platelet counts have a lower quality of life in emotional and social aspects.