Minghao Zhang, Xiaoming Wang, Ting Pu, Xiaoyu Jiao, Ting Li, Jie Wei, Yuxuan Cheng, Wan Zhang, Jun Peng, Aijun Zhang
{"title":"儿科ITP的早期反应和长期预后:未来管理策略的探讨。","authors":"Minghao Zhang, Xiaoming Wang, Ting Pu, Xiaoyu Jiao, Ting Li, Jie Wei, Yuxuan Cheng, Wan Zhang, Jun Peng, Aijun Zhang","doi":"10.1111/bjh.20209","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>Immune thrombocytopenia (ITP) is the most common immunological haemorrhagic disease in childhood. Our retrospective study analysed hospitalized paediatric ITP patients to identify determinants of early treatment response and long-term clinical outcomes. The study found that younger children had a higher 7-day complete response (CR) rate and were more likely to achieve CR in the early stages (<i>p</i> = 0.003, hazard ratio = 0.960 [0.934–0.986]). There was no difference in early partial response or CR rates between subgroups of intravenous immunoglobulin at different doses (<i>p</i> > 0.05). Age was identified as an independent factor affecting long-term prognosis, with older children experiencing a longer duration of illness (<i>p</i> < 0.001, odds ratio = 1.225 [1.143–1.309]). The long-term prognosis was not influenced by early treatment response. Despite this, current first-line treatments for children cannot prevent disease recurrence or improve long-term outcomes. Whether treatment strategies based on risk stratification and early combination of second-line treatments can decrease glucocorticoid use, reduce the likelihood of chronic ITP, improve quality of life and optimize long-term prognosis remains to be determined. The optimization of treatment regimens based on risk stratification warrants further investigation.</p>\n </div>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"207 2","pages":"535-542"},"PeriodicalIF":3.8000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early response and long-term prognosis of paediatric ITP: Exploration of future management strategies\",\"authors\":\"Minghao Zhang, Xiaoming Wang, Ting Pu, Xiaoyu Jiao, Ting Li, Jie Wei, Yuxuan Cheng, Wan Zhang, Jun Peng, Aijun Zhang\",\"doi\":\"10.1111/bjh.20209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>Immune thrombocytopenia (ITP) is the most common immunological haemorrhagic disease in childhood. Our retrospective study analysed hospitalized paediatric ITP patients to identify determinants of early treatment response and long-term clinical outcomes. The study found that younger children had a higher 7-day complete response (CR) rate and were more likely to achieve CR in the early stages (<i>p</i> = 0.003, hazard ratio = 0.960 [0.934–0.986]). There was no difference in early partial response or CR rates between subgroups of intravenous immunoglobulin at different doses (<i>p</i> > 0.05). Age was identified as an independent factor affecting long-term prognosis, with older children experiencing a longer duration of illness (<i>p</i> < 0.001, odds ratio = 1.225 [1.143–1.309]). The long-term prognosis was not influenced by early treatment response. Despite this, current first-line treatments for children cannot prevent disease recurrence or improve long-term outcomes. Whether treatment strategies based on risk stratification and early combination of second-line treatments can decrease glucocorticoid use, reduce the likelihood of chronic ITP, improve quality of life and optimize long-term prognosis remains to be determined. The optimization of treatment regimens based on risk stratification warrants further investigation.</p>\\n </div>\",\"PeriodicalId\":135,\"journal\":{\"name\":\"British Journal of Haematology\",\"volume\":\"207 2\",\"pages\":\"535-542\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-06-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Haematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/bjh.20209\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Haematology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/bjh.20209","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Early response and long-term prognosis of paediatric ITP: Exploration of future management strategies
Immune thrombocytopenia (ITP) is the most common immunological haemorrhagic disease in childhood. Our retrospective study analysed hospitalized paediatric ITP patients to identify determinants of early treatment response and long-term clinical outcomes. The study found that younger children had a higher 7-day complete response (CR) rate and were more likely to achieve CR in the early stages (p = 0.003, hazard ratio = 0.960 [0.934–0.986]). There was no difference in early partial response or CR rates between subgroups of intravenous immunoglobulin at different doses (p > 0.05). Age was identified as an independent factor affecting long-term prognosis, with older children experiencing a longer duration of illness (p < 0.001, odds ratio = 1.225 [1.143–1.309]). The long-term prognosis was not influenced by early treatment response. Despite this, current first-line treatments for children cannot prevent disease recurrence or improve long-term outcomes. Whether treatment strategies based on risk stratification and early combination of second-line treatments can decrease glucocorticoid use, reduce the likelihood of chronic ITP, improve quality of life and optimize long-term prognosis remains to be determined. The optimization of treatment regimens based on risk stratification warrants further investigation.
期刊介绍:
The British Journal of Haematology publishes original research papers in clinical, laboratory and experimental haematology. The Journal also features annotations, reviews, short reports, images in haematology and Letters to the Editor.