Idiopathic Thrombocytopenic Purpura in Elderly Patients: A Two-center Retrospective Study of 41 Cases
- Corresponding Author:
- Emmanuel Andres
Professor, Department of Internal Medicine
Medical Clinic B, Civil Hospital
University Hospital of Strasbourg
1 place de l'Hôpital
67091 Strasbourg cedex, France
Tel: +33 (0)3 88 11 50 66
Fax: +33 (0)3 88 11 62 62
E-mail: [email protected]
Received Date: March 24, 2015; Accepted Date: May 15, 2015; Published Date: May 19, 2015
Citation: Andres E, Zulfiqar AA, Serraj K, Zimmer J, Vogel T, et al. (2015) Idiopathic Thrombocytopenic Purpura in Elderly Patients: A Twocenter Retrospective Study of 41 Cases. J Blood Disord Transfus 6:278. doi:10.4172/2155-9864.1000278
Copyright: © 2015 Andres A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: This work aimed to report our observations on idiopathic or immune thrombocytopenic purpura (ITP) in elderly patients.
Patients and Methods: We retrospectively reviewed a cohort of 41 consecutive elderly ITP patients (≥65 years old) in two ITP reference centers, namely the university hospital groups of Strasbourg and Reims, France. We particularly analyzed patient clinical characteristics, along with the therapies used and side-effects, and patient response rates.
Results: The mean age of the 41 patients was 76.7 years (range: 65-91), 21 (51%) were older than 75 years and 27 were female. Initial presentations included the following: thrombocytopenia revealed by routine blood count or bleeding limited to the skin in 27 cases (66%); severe cutaneous bleeding or visceral bleeding in one or more other sites in 14 (34%). The mean platelet count was 34.4 x 109/L (range: 1-120). Spontaneous remission and complete response under therapy were reported in eight patients (20%) and 33 (80%) still exhibited chronic ITP at time of writing. There were three deaths during long-term follow-up. After 6 months, the response rate was 35% with corticosteroids, 50% with splenectomy, and 40% with danazol. Side-effects were reported in 100% of elderly ITP patients, with 60% and 50% corresponding to corticosteroids and danazol, respectively. The response rate to biological agents, namely rituximab and thrombopoietin (TPO) receptor agonists, was 80%, with no adverse effects observed.
Conclusions: Our results confirm that age influences the hemorrhagic pattern of ITP expression as well as responses to and adverse effects of conventional ITP therapies.