2026 Volume 63 Issue 1 Pages 39-44
Background: The management of pediatric immune thrombocytopenia (ITP) has undergone substantial changes in recent years. In this retrospective review, we examined treatment patterns, hospitalization duration, and related clinical factors in 183 patients aged ≤20 years diagnosed with primary ITP at our institution.
Participants and Methods: Patients diagnosed between April 2004 and March 2025 were categorized into Period A (first 10 years after opening) and Period B (subsequent 11 years). Medical records were reviewed to obtain demographic data, initial treatment, bone marrow examination status, secondary therapy use (rituximab, thrombopoietin receptor agonists [TPO RA]), and total hospitalization days for comparative analysis.
Results: Patient demographics were similar between periods. Prednisolone use decreased from 55.4% in Period A to 25.3% in Period B, whereas intravenous immunoglobulin (IVIG) use increased from 29.3% to 56.0%. Bone marrow examinations declined from 79.1% to 53.8%. In Period B, rituximab and TPO RA were administered as secondary treatments. Median hospitalization decreased from 10.0 to 6.0 days. Multivariate analysis indicated that patients receiving IVIG as initial therapy experienced shorter stays.
Discussion: The rapid IVIG effects, reduced use of invasive testing, broader adoption of second-line therapies, and treatment strategies emphasizing Health-Related Quality of Life (HRQoL) likely contributed to shorter hospitalization and improved HRQoL for patients and their families. These findings underscore the urgent need for the adoption of pediatric ITP-specific HRQoL assessment tools.
