Initial Management of Childhood Acute Immune Thrombocytopenia: Single-Center Experience of 32 Years.

Abstract:

:Immune thrombocytopenia (ITP) is an acute self-limited disease of childhood, mostly resolving within 6 months irrespective of whether therapy is given or not. Treatment options when indicated include corticosteroids, intravenous immune globulin (IVIG), and anti-RhD immunoglobulin. We reviewed our 32 years' experience for first-line therapy of acute ITP. Five hundred forty-one children (mean age: 5.3 years) diagnosed and treated for ITP were evaluated retrospectively. Among 491 acute ITP patients, IVIG was used in 27%, high-dose steroids in 27%, low-dose steroids in 20%, anti-D immunoglobulin G (IgG) in 2%, and no therapy in 22%. When the initial response (platelets >50 × 10(9)/L) to first-line treatment modalities were compared, 89%, 84%, and 78% patients treated by low-dose steroids, high-dose steroids, and IVIG responded to treatment, respectively (P > .05). Mean time to recovery of platelets was 16.8, 3.8, and 3.0 days in patients treated with low-dose steroids, high-dose steroids, and IVIG, respectively (P < .0001). Thrombocytopenia recurred in 23% of low-dose steroid, 39% of high-dose steroid, and in 36% of IVIG (P < .0001) treatment groups. Of 108 patients who were observed alone, 4 (3%) had a recurrence on follow-up and only 2 of these required treatment subsequently. Recurrence was significantly less in no therapy group compared with children treated with 1 of the 3 options of pharmacotherapy (P < .0001). Response rates were similar between patients treated by IVIG and low- and high-dose steroids; however, time to response was slower in patients treated with low-dose steroids compared with IVIG and high-dose steroids.

journal_name

Pediatr Hematol Oncol

authors

Yildiz I,Ozdemir N,Celkan T,Soylu S,Karaman S,Canbolat A,Dogru O,Erginoz E,Apak H

doi

10.3109/08880018.2015.1040931

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

406-14

issue

6

eissn

0888-0018

issn

1521-0669

journal_volume

32

pub_type

杂志文章
  • The effects of megadose methylprednisolone therapy on the immune system in childhood immune thrombocytopenia.

    abstract::Immune thrombocytopenia (ITP) is a frequently encountered disease in childhood. Recent reports pointed to the benefit of high-dose steroid in ITP treatment since it resulted in a better outcome in a shorter time than IV immunoglobulin therapy. In the authors' clinic, mainly after 1984, megadose methyl prednisolone (MD...

    journal_title:Pediatric hematology and oncology

    pub_type: 临床试验,杂志文章

    doi:10.1080/08880010590964291

    authors: Yetgin S,Yenicesu IC,Ersoy F

    更新日期:2005-07-01 00:00:00

  • Soft tissue density variations in thalassemia major: a possible pitfall in lumbar bone mineral density measurements by dual-energy X-ray absorptiometry.

    abstract::Osteoporosis is common in patients with thalassemia major. A 16-year-old patient with thalassemia major was referred for evaluation of osteoporosis. The results of dual-energy X-ray absorptiometry in a patient with thalassemia major are presented. The patient underwent measurements of the spine in both AP and lateral ...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880010500278707

    authors: Yildiz M,Canatan D

    更新日期:2005-12-01 00:00:00

  • Allogeneic hemopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission-similar outcomes after matched related and unrelated donor transplant: a study of the Spanish Working Party for Blood and Marrow Trans

    abstract::The authors report the results of 58 children with ALL in 2CR after related (n = 31) or unrelated (n = 27) AHSCT. Characteristics at diagnosis and initial and after relapse antileukemic treatment were similar in the related donor (RD) and the unrelated donor (UD) groups. Conditioning consisted of TBI/CY +/- VP-16 for ...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880010802016557

    authors: Muñoz A,Diaz-Heredia C,Diaz MA,Badell I,Verdeguer A,Martinez A,Gomez P,Perez-Hurtado JM,Bureo E,Fernandez-Delgado R,Gonzalez-Valentin ME,Maldonado MS

    更新日期:2008-06-01 00:00:00

  • How to interpret high levels of distress when using the Distress Thermometer in the long-term follow-up clinic? A study with Acute Lymphoblastic Leukemia survivors.

    abstract:OBJECTIVES:Recent guidelines recommend to assess emotional distress in pediatric oncology during treatment and in after care. One tool used to do this is the distress thermometer (DT), a simple tool which has almost exclusively been studied in its screening abilities. Given its increased used as a measure of distress p...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880018.2017.1338805

    authors: Pépin AJ,Lippé S,Krajinovic M,Laverdière C,Michon B,Sinnett D,Sultan S

    更新日期:2017-04-01 00:00:00

  • Changing pattern of treatment policies invalidates the use of C-reactive protein level and hyponatremia as indicators of sepsis in children with malignancies.

    abstract::We evaluated serum C-reactive protein (CRP) level and serum sodium concentration as early indicators of bacteremia in neutropenic children in two different series in 1983-1984 (49 bacteremias) and 1989-1990 (29 bacteremias). During the earlier period, the goal was to avoid unnecessary antimicrobial therapy. Currently ...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019209016609

    authors: Riikonen P,Saarinen UM,Perkkiö M,Hovi L,Siimes MA

    更新日期:1992-10-01 00:00:00

  • Vanilmandelic acid and homovanillic acid levels in patients with neural crest tumor: 24-hour urine collection versus random sample.

    abstract::Neuroblastoma is the most common solid tumor in childhood and is the most frequent neural crest tumor (NCT). More than 90% of the patients excrete high levels of vanilmandelic acid (VMA) and homovanillic acid (HVA) in the urine. Original biochemical methods for measuring these two metabolites of catecholamines employe...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019709009495

    authors: Gregianin LJ,McGill AC,Pinheiro CM,Brunetto AL

    更新日期:1997-05-01 00:00:00

  • Endemic Burkitt Lymphoma: Long-term Outcome in 87 Patients Who Presented With Paraplegia in Cameroon.

    abstract::The reported long-term outcome of endemic Burkitt lymphoma (eBL) patients who present with paraplegia is largely unknown. Records of BL patients treated with comparable short-interval cyclophosphamide chemotherapy schedules between 2004 and 2014 at three Baptist mission hospitals in Cameroon were reviewed. Survivors w...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章,多中心研究

    doi:10.3109/08880018.2015.1085936

    authors: Hesseling PB,Mbah G,Kouya F,Kimbi C,Nfor P,Kaah J,Kuruvilla R,Best A,Wharin P

    更新日期:2015-01-01 00:00:00

  • Percutaneous transhepatic biliary drainage in an infant with obstructive jaundice caused by neuroblastoma.

    abstract::Neuroblastoma presenting with obstructive jaundice is a rare event. Management of this condition includes surgery, chemotherapy, radiotherapy, temporary cholecystostomy tube, endoscopic retrograde cholangiopancreatography (ERCP), and internal biliary drainage (IBD). We herein describe our experience with one infant af...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880018.2014.981901

    authors: Saettini F,Agazzi R,Giraldi E,Foglia C,Cavalleri L,Morali L,Fasolini G,Spotti A,Provenzi M

    更新日期:2015-04-01 00:00:00

  • Pneumatosis cystoides intestinalis with abdominal free air in a 2-year-old girl after allogeneic bone marrow transplantation.

    abstract::A 2-year-old girl with acute lymphoblastic leukemia (ALL) showing a t(4;11)(q21;q23) karyotype underwent allogeneic bone marrow transplantation (BMT) with the conditioning regimen of L-PAM (70 mg/m2/d for 3 days), busulfan (140 mg/m2/d for 2 days), and total body irradiation (12 Gy). On day 57, the patient developed p...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019809009512

    authors: Takanashi M,Hibi S,Todo S,Sawada T,Tsunamoto K,Imashuku S

    更新日期:1998-01-01 00:00:00

  • Dysgerminoma in a child with ataxia-telangiectasia.

    abstract::Ataxia-telangiectasia is an autosomal recessive disease characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, immunodeficiency, high incidence of cancer, and increased sensitivity to ionizing radiation. The authors report a case of dysgerminoma in a child with high alpha-fetoprotein, CA125 and...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章,评审

    doi:10.1080/08880010701451434

    authors: Koksal Y,Caliskan U,Ucar C,Yurtcu M,Artac H,Ilerisoy-Yakut Z,Reisli I

    更新日期:2007-09-01 00:00:00

  • Characterization of the coagulation profile in children with liver disease and extrahepatic portal vein obstruction or shunt.

    abstract:INTRODUCTION:Chronic liver disease causes a disruption of procoagulant and anticoagulant factors, resulting in a fragile state, prone to increased rates of both bleeding and thrombosis. Currently, there is limited literature describing the changes observed in pediatric liver disease and extrahepatic portal vein obstruc...

    journal_title:Pediatric hematology and oncology

    pub_type: 临床试验,杂志文章

    doi:10.1080/08880018.2017.1313919

    authors: Beattie W,Magnusson M,Hardikar W,Monagle P,Ignjatovic V

    更新日期:2017-03-01 00:00:00

  • Etoposide in Langerhans cell histiocytosis in children: a preliminary experience.

    abstract::Treatment of Langerhans cell histiocytosis (LCH) is yet to be established. We treated seven patients with etoposide alone at a dose of 100 mg/m2/day for 3 days given every 3 to 4 weeks for six cycles. Three patients had received prior chemotherapy, two patients were less than 2 years of age, and two had liver dysfunct...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019609030806

    authors: Basade MM,Nair CN,Kurkure PA,Pai SK,Advani SH

    更新日期:1996-03-01 00:00:00

  • Clinical versus laboratory tumor lysis syndrome in children with acute leukemia.

    abstract::Renal and metabolic complications of tumor lysis syndrome (TLS) were recognized frequently in the 1960s and 1970s. Strategies were designed to prevent TLS. We conducted a retrospective chart review study to identify the current TLS risk in children with acute leukemia. Children were considered to have "laboratory tumo...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019509029545

    authors: Kedar A,Grow W,Neiberger RE

    更新日期:1995-03-01 00:00:00

  • Homozygous 23-bp insertion of endothelial protein c receptor gene in a child with fatal sepsis.

    abstract::Endothelial protein C receptor (EPCR) is primarily localized on the endothelial cells of large blood vessels and is very low or absent in the microvascular endothelium of most tissues. EPCR augments the thrombin/thrombomodulin-dependent activation of protein C by 5- to 20-fold. EPCR appears to be physiologically signi...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880010701198811

    authors: Kendirli T,Ciftçi E,Ince E,Yurdakul E,Kansu A,Akar N

    更新日期:2007-04-01 00:00:00

  • Immunocompetent cells and lymphocyte reactivity to mitogens in levamisole-treated brain tumor children.

    abstract::This study investigated the influence of levamisole therapy on immunocompetent cells and lymphocyte reactivity to mitogens in 25 children with brain tumor. Eleven (11/25) patients were receiving chemotherapy and immunomodulating drug levamisole 3 months after neurosurgery, during maintenance chemotherapy, 2.5 mg/kg of...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/088800199277164

    authors: Hajnzić TF,Kastelan M,Lukac J,Hajnzić T

    更新日期:1999-07-01 00:00:00

  • Medulloblastoma-biology and microenvironment: a review.

    abstract::Medulloblastoma (MB) is a cancer of the cerebellum and the most common primary pediatric malignancy of the central nervous system. Classified as a primitive neural ectoderm tumor; it is thought to arise from granule cell precursors in the cerebellum. The standard of care consists of surgery, chemotherapy and age-depen...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章,评审

    doi:10.3109/08880018.2012.698372

    authors: Byrd T,Grossman RG,Ahmed N

    更新日期:2012-09-01 00:00:00

  • Hodgkin's disease in association with Down syndrome: a case report.

    abstract::The increased incidence of malignancies, especially acute leukemia, in Down syndrome has been clearly established. The association of Hodgkin's disease with Down syndrome has not been extensively documented, and only a few cases have been reported. We present here a case report of Hodgkin's disease in an 11-year-old f...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019609030860

    authors: Kusumakumary P,Jyothirmayi R,Chellam VG,Krishnan NM

    更新日期:1996-09-01 00:00:00

  • The clinical findings and prophylactic treatment in children with factor X deficiency.

    abstract::Factor X (FX) is the component of both extrinsic and intrinsic coagulation cascade and is the first enzyme of the common pathway which results in thrombus. Congenital FX deficiency (FXD) is an extremely rare coagulation defect. In this study, we aimed to investigate the clinical and laboratory data of the patients dia...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880018.2013.782380

    authors: Karabel M,Söker M,Yıldırım AT,Oymak Y,Kelekçi S,Karabel D

    更新日期:2013-11-01 00:00:00

  • The elevated markers of hypercoagulability in children with Henoch-Schönlein purpura.

    abstract::Twenty-eight children with HSP and 79 healthy children were entered into study. Activities of protein C, free-protein S and antithrombin, activated protein C resistance, levels of fibrinogen. D-dimer, thrombin-antithrombin complex (TAT), prothrombin fragments 1 + 2 (PF(1+2)), and von Willebrand factor antigen (vWAg) a...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880010590896251

    authors: Yilmaz D,Kavakli K,Ozkayin N

    更新日期:2005-01-01 00:00:00

  • Male gonadal function in survivors of childhood Hodgkin and non-Hodgkin lymphoma.

    abstract::The aim of this study was to investigate the impact of therapy on long-term gonadal function of young people cured of childhood lymphomas and to assess whether a prepubertal state during the treatment protects the gonads from chemotherapy and/or radiotherapy late effects. Clinical evaluation, semen analysis, and endoc...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/088800100276415

    authors: Ben Arush MW,Solt I,Lightman A,Linn S,Kuten A

    更新日期:2000-04-01 00:00:00

  • Alectinib is effective, safe and tolerable in an adolescent with stage IVB ALK-rearranged adenocarcinoma of the lung.

    abstract::Anaplastic lymphoma kinase (ALK) inhibitors such as crizotinib and alectinib have been shown to have significant activity in ALK-rearranged non-small cell lung cancers (NSCLC). There are no data for alectinib's safety or efficacy in younger patients, though it is superior to crizotinib in adult trials. We present a 14...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880018.2018.1541492

    authors: Balzer BWR,Loo C,Wegner EA,Nath CE,Lee S,Smith C,Lewis CR,Trahair TN,Anazodo AC

    更新日期:2018-01-01 00:00:00

  • The effect of deferasirox on endocrine complications in children with thalassemia.

    abstract::Endocrine system dysfunctions are the significant complications of excessive iron overload in beta thalassemia patients. The aim of this study was to evaluate the long-term effect of chelation with deferasirox on endocrine complications. The study group consisted of children with beta thalassemia who had been evaluate...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880018.2020.1734124

    authors: Bilgin BK,Yozgat AK,Isik P,Çulha V,Kacar D,Kara A,Ozbek NY,Yarali N

    更新日期:2020-09-01 00:00:00

  • Management of nephroblastoma with intracardiac extension: three case reports and review of the literature.

    abstract::A single institution's experience of three patients with nephroblastoma extending via the inferior vena cava to the right heart is described. The case reports and the pertinent literature illustrate that preoperative failure to detect the intracardial extension increases the risk of right outflow obstruction and pulmo...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章,评审

    doi:10.3109/08880019109028807

    authors: Kremens B,Sadony V,Goepel M,Hellinger A,Havers W

    更新日期:1991-10-01 00:00:00

  • Bone marrow recovery of hematopoietic stem cells and microenvironment after chemotherapy in childhood acute lymphoblastic leukemia: consecutive observations according to chemotherapy schedule.

    abstract::We investigated bone marrow (BM) recovery of hematopoietic stem cells (HSC) and hematopoietic microenvironment after chemotherapy in childhood acute lymphoblastic leukemia (ALL). Twenty-nine de novo childhood ALL patients were enrolled and BM biopsy sections at diagnosis (BM0), after induction (BM1), consolidation (BM...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.1080/08880018.2019.1623354

    authors: Park SH,Lee MJ,Park CJ,Jang S,Seo EJ,Im HJ,Seo JJ

    更新日期:2019-05-01 00:00:00

  • Advanced nasopharyngeal carcinoma in the young: The Northern Israel Oncology Center experience, 1973-1991.

    abstract::Between 1973 and 1991, 10 patients with locally advanced [stages III and IV] nasopharyngeal carcinoma were treated at the Northern Israel Oncology Center. All patients were treated with wide-field irradiation to the primary tumor, including the base of skull, neck, and supraclavicular region. After 1984, 6 patients al...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019509029568

    authors: Arush MW,Stein ME,Rosenblatt E,Lavie R,Kuten A

    更新日期:1995-05-01 00:00:00

  • Shift from fetal to adult hemoglobin production in a preterm infant after exchange transfusion: a quantitative approach.

    abstract::To evaluate the quantitative aspects of the shift in production from fetal hemoglobin (HbF) to adult hemoglobin (HbA), the HbF and HbA mass were estimated in a preterm infant (gestational age 29 weeks) for 22 weeks after an exchange transfusion the second day of life, leading to an initial HbA% of 100. Up until the es...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019809016572

    authors: Refsum HE,Bechensteen AG,Lindemann R

    更新日期:1998-09-01 00:00:00

  • Ondansetron and tropisetron in the control of nausea and vomiting in children receiving combined cancer chemotherapy.

    abstract::Ondansetron (Zofron, Glaxo) and tropisetron (Navoban, Sandoz) are selective serotonin (5HT3) antagonists that have proven very effective in the prevention of vomiting and nausea in adults and children receiving cancer chemotherapy. This study compared the efficacy of the two agents in the prevention of vomiting and na...

    journal_title:Pediatric hematology and oncology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1080/088800199277425

    authors: Stiakaki E,Savvas S,Lydaki E,Bolonaki I,Kouvidi E,Dimitriou H,Kambourakis A,Kalmanti M

    更新日期:1999-03-01 00:00:00

  • Transient encephalopathy following a single exposure of high-dose methotrexate in a child with acute lymphoblastic leukemia.

    abstract::An episode of transient encephalopathy after the first course of intravenous high-dose methotrexate (HD-MTX; 1000 mg/m2) was observed in a 4-year-old girl with acute lymphoblastic leukemia. The neurological abnormalities took place 5 days after HD-MTX therapy. She experienced complex partial seizure and left hemipares...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章

    doi:10.3109/08880019209018331

    authors: Kubo M,Azuma E,Arai S,Komada Y,Ito M,Sakurai M

    更新日期:1992-04-01 00:00:00

  • Inflammatory and immune response genes: A genetic analysis of inhibitor development in Iranian hemophilia A patients.

    abstract::A major problem of hemophilia A (HA) treatment is the development of factor VIII (FVIII) inhibitor, which usually occurs shortly after initiating replacement therapy. Several studies showed the correlation between inhibitor development and polymorphisms in inflammatory and immune response genes of HA patients; however...

    journal_title:Pediatric hematology and oncology

    pub_type: 临床试验,杂志文章

    doi:10.1080/08880018.2019.1585503

    authors: Naderi N,Yousefi H,Mollazadeh S,Seyed Mikaeili A,Keshavarz Norouzpour M,Jazebi M,Moazezi Nekooi Asl SS,Namvar A,Azizi Saraji A,Agi E,Bolhassani A

    更新日期:2019-02-01 00:00:00

  • Successful multimodal therapy for kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon: case report and review of the literature.

    abstract::We present the management challenge provided by a patient with kaposiform hemangioendothelioma associated with Kasabach-Merritt phenomenon. A female child presented at 14 months of age with an ecchymotic swelling of her right upper arm and axilla. Subsequently, she developed profound thrombocytopenia and hypofibrinoge...

    journal_title:Pediatric hematology and oncology

    pub_type: 杂志文章,评审

    doi:10.3109/08880019809014013

    authors: Blei F,Karp N,Rofsky N,Rosen R,Greco MA

    更新日期:1998-07-01 00:00:00