期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 196, 期 5, 页码 1262-1270出版社
WILEY
DOI: 10.1111/bjh.17935
关键词
purpura; thrombocytopenic; idiopathic; elderly; epidemiology; immune thrombocytopenia
类别
资金
- Delegation Regionale a la Recherche Clinique des Hopitaux de Toulouse 2012
- French National Society of Internal Medicine (Societe Nationale Francaise deMedecine Interne)
- French referral centre for autoimmune cytopenia
- French National Centre for Rare Diseases in Immunohaematology (MaRIH)
- CSL Behring
- Novartis
Data on the presentation and management of primary immune thrombocytopenia (ITP) in very elderly patients (VEPs; aged >= 80 years) are lacking. This study aimed to describe ITP in this subgroup and found that VEPs have a higher likelihood of severe bleeding, with female sex and a platelet count of <20 x 10(9)/l being associated with bleeding. Exposure to anticoagulants is strongly associated with severe bleeding in VEPs.
Data about the presentation and the management of primary immune thrombocytopenia (ITP) in very elderly patients (VEPs; aged >= 80 years) are lacking. The aim of the present study was to describe ITP in this subgroup. The data source was the prospective CARMEN-France registry. Patients included between 2013 and 2018 were selected. ITP presentation and management in VEPs was compared to elderly patients (EPs; aged 65-79 years). We assessed factors associated with bleeding at ITP onset in VEPs. Of 541 patients, 184 were included: 87 in the VEP group and 97 in the EP group. The mean age was 85 center dot 7 years in the VEP group. Comorbidities were more frequent in the VEP group (67 center dot 4% vs. 47 center dot 9%). The median platelet count at ITP onset was similar but severe bleeding tended to be more frequent in VEPs (10 center dot 3% vs. 4 center dot 1%, P = 0 center dot 1) as well as mortality. Exposure to ITP drugs, response to first-line treatment, need of second-line treatment, evolution towards persistency, occurrence of bleeding, infection and thrombosis did not differ between groups. In VEPs, factors associated to bleeding were female sex [odds ratio (OR) 4 center dot 75, 95% confidence interval (CI) 1 center dot 31-17 center dot 32] and platelet count of <20 x 10(9)/l (OR 10 center dot 05, 95% CI 4 center dot 83-67 center dot 39). Exposure to anticoagulants was strongly associated with severe bleeding (OR 7 center dot 61, 95% CI 1 center dot 77-32 center dot 83).
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