Background: The epidemiology of idiopathic thrombocytopenic purpura (ITP) is not well known. Recent retrospective studies have indicated that two-thirds of adult ITP patients are at risk of developing a chronic form of the disease.

Aims: The objectives of this study are to investigate the predictive factors of chronicity in adult patients with an ITP, to describe the clinical and biological characteristics and to specify the type of first-line treatments in this population as well as their evolution.

Methods: This is a monocentric retrospective study that included all patients diagnosed and monitored for an ITP over a period of 4 years.

Results: Our cohort consisted of 163 patients with a mean age of 41.2 with a sex ratio of F / H of 2.41. In 27% of the cases, the circumstances of discovery were fortuitous. The median bleeding score for Khellaf was 4. The mean platelet count was 25.6 G / L. A myelogram was performed in 75.5% of the cases of which 100% of the more than 60 years. A “watch and wait” strategy was decided for 16 patients. 88.9% of patients received treatment with corticosteroids with a CR and failure rate of 48.5% and 18.4% respectively. Of our patients 30.7% have progressed to a chronic ITP. The predictive factors for chronicity at 12 months were platelet count (p = 0.001) and severity of hemorrhagic syndrome (p = 0.05). Indeed, a platelet count of more than 30G / L was associated with< a high probability of passage to chronicity (p = 0.02).

Conclusions: The adult ITP is a disease frequently associated with bleeding where one third of the patients progress to a chronic form. High platelet counts and severity of bleeding at diagnosis are associated with a risk of progression to chronic ITP.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/predictive-factors-of-chronicity-in-adult-idiopathic-thrombocytopenic-purpura/