Abstract
In order to delineate the clinical aspects relating to “intractable” nature of ITP, our experience on 154 cases was analyzed. The patient population showed following characteristics; average onset-age of 35 years, ranging 0∼79, male/female ratio of 43/111, acute/chronic form of 24/126 with 4 unclassified. 35 cases were observed without receiving any standard forms of therapy, and the remainder was managed by relatively modest treatment including splenectomy in 14 cases. Patients were followed for 5 years on average. There were 13 deaths (8.4%), of which 6 were directly related to bleeding and 5 were to complications and 2 were ascribable to unrelated causes. Initial severe thrombocytopenia was a significant prognostic variable. The increment of platelets during the follow-up was less than 50×108/μl in 46% of cases, while platelet count at the last observation remained less than 50×108/μl in 33% of cases. 17% of cases with chronic ITP suffered from mild bleeding tendency at the last follow-up. However, the activity in daily life was maintained reasonably well in the majority of cases. In addition, the disease process appeared to subside gradually to give a stable platelet count above 100×103/μl in 40% of chronic form. For practical management of patients, all these aspects should be taken into account.
