Changing trends in the UK management of childhood ITP.

Abstract

To compare the treatment of childhood immune thrombocytopenia (ITP) with historical practice in the UK. Data collection through a national UK Childhood ITP registry (http://www.uk-itp.org) started in January 2007. UK hospitals. Children admitted with a new diagnosis of acute ITP and their treating physicians. Bleeding severity, platelet count, disease management and outcome from the time of presentation to 6 months. Data from 225 children were analysed. 54% of children had clinically mild, 42% had moderate and 4% had severe disease as defined previously. The mean platelet counts at diagnosis for these groups were 14, 8 and 6×10(9)/l respectively. Children with mild disease had fewer bleeding sites (1.9), compared with moderate (2.5) or severe disease (3.6). There was one intracranial haemorrhage reported. At 6 months' follow-up, 32% had a persistent platelet count <150×10(9)/l, but only 4.8% had a count <20. The proportion of UK children receiving platelet-raising treatment was noted to decrease from 61% in 1995 to 38% in 2000. The current UK 2009 registry data show a continued decrease in treatment to 16% of all the children. In contrast, historical international data report 69% of children receiving interventional therapy. The current UK practice has shown a continued reduction in the number of children receiving treatment in comparison with historical data and international practice.