Long-Term Follow-Up Results of Newly Diagnosed, Untreated Adult Primary Immune Thrombocytopenia Patients in Turkey

Vural Aşki¹, Berber İlhami², Sarıcı Ahmet², Erkurt Mehmet Ali², Kaya Emin², Kuku İrfan² 

¹Adiyaman Research and Training Hospital, Department of Internal Medicine, Adıyaman, Turkey - ²İnönü University Medical Faculty Department of Internal Medicine, Division of Haematology, Malatya, Turkey

Objective: There are very few studies about long-term follow-up results of newly diagnosed, untreated adult primary immune thrombocytopenia (ITP) patients, and the results differ from each other. Also, no study has so far been conducted in Turkey. The aim of this study was to determine the number of newly diagnosed adult ITP patients whose treatment started, the time until the start of treatment, and the rate of patients who did not receive any treatment during the follow-up period.

Materials and methods: A total of 205 newly diagnosed ITP patients were retrospectively evaluated in this study; primary treatment was applied to 126 patients (61.5%) after diagnosis, and 79 patients (38.5%) were followed without treatment. 

Results: After ITP diagnosis, corticosteroid therapy was started for various reasons at a mean of 20 months (1-60 months) of follow-up in 24 (30.4%) of 79 patients who were followed without treatment. In 12 (50%) of 24 patients who were treated, treatment was applied because platelet counts were lower than 30x109/L or due to surgery or childbirth (50%) although platelet counts were higher than 30x109/L. With the deepening of thrombocytopenia (<30x10⁹/L), treatment was initiated in 12 patients until the mean time of 10 months (1-58 months), and treatment was started in 9 (75%) of these patients in the first 12 months.

Conclusion: We demonstrated that the majority (70%) of newly diagnosed untreated ITP patients had no treatment indication during follow-up at 60 months. Although the thrombocyte count was over 30.000/mm3 in half of the patients who had treatment indications during the follow-up period, treatment was started due to other reasons (surgery, pregnancy, etc.).