İnönü Üniversitesi Tıp Fakültesi çocuk hematoloji onkoloji bilim dalında takip edilen idiyopatik trombositopenik purpuralı hastaların retrospektif analizi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnönü Üniversitesi Tıp Fakültesi Çocuk Hematoloji Onkoloji Bilim Dalında Takip Edilen İdiyopatik Trombositopenik Purpuralı Hastaların Retrospektif Analizi Amaç: Bu çalışmada, ITP hastalarının dosyaları retrospektif olarak incelenerek hastaların başvuru anındaki demografik bilgileri, klinik özellikleri, farklı tedavi seçeneklerinin etkinliklerinin karşılaştırılması ve hastaların klinik prognozlarının belirlenmesi amaçlanmıştır. Materyal ve Metot: Bu araştırmanın evrenini; İnönü Üniversitesi Turgut Özal Tıp merkezinde 2010–2020 tarihleri arasında tanı almış ITP hastaları oluşturmaktadır. Araştırmanın örneklemi; yapılan güç analizi sonucunda 60 kronik, 60 akut ve persistan olmak üzere en az 120 ITP hastası olarak belirlenmiştir. Veriler hasta dosyaları taranarak elde edilmiştir. Araştırmada toplanan verilerin değerlendirilmesinde yüzde, frekans, Ki Kare analizi, bağımlı ve bağımsız gruplar için t testleri kullanılmıştır. Bulgular: Çalışmaya dahil edilen %53.33'ü kız, %46.67'si erkek 120 hastanın ortalama tanı yaşları 6.88±4.70, ortalama takip süresi 3.63±3.00 yıl olmuştur. En düşük ortalama yaş persistan ITP'li, en yüksek ortalama yaş ise kronik ITP'li gruba aittir. Hastalar en fazla yaz mevsiminde tanı almışlardır. Akut ITP grubunda kız/erkek oranı 1.04, persistan ITP grubunda 0.29, kronik ITP grubunda 1.50 olarak tespit edilmiştir. Hastaların tanı anındaki ortalama trombosit sayısı 18915±23133/mm3 'tür. En fazla ciltte mor leke şikâyeti ile başvuru yapılmıştır. En fazla başvuru muayene bulgusu ekimozdur. Hastaların %52.94'ünde enfeksiyon, %5.00'inde aşı öyküsü mevcuttur. Hastaların %95.00'ine kemik iliği aspirasyonu yapılmış, %76.32'sinde megakaryositlerin artmış olduğu görülmüştür. Tedavisiz izlemdeki hastaların tamamı başlangıçta spontan remisyona girmiş ve %33.33'ü takipte kronikleşmiştir. İlk tedavi olarak standart doz metilprednizolon verilen hastaların tamamı kronik seyir göstermiştir. Hastalara verilen tedavilerle, bu tedavilere alınan yanıtlar arasında anlamlı bir ilişki saptanmıştır. Akut ITP'li hastaların %94.12'si başlangıç tedavilerinde tam remisyona girmiştir. Persistan ITP'li tüm hastalar tam remisyona girerken, kronik ITP'li hastaların %58.33'ü parsiyel, %35.00'i ise tam remisyona girmiştir. 120 hastanın tümünde yanıtsızlık %3.33, kısmi yanıt %29.17, tam yanıt ise %67.50 olarak tespit edilmiştir. Sonuç: ITP'li çocuklarda geç tanı yaşı, başvuru anındaki yüksek trombosit sayısı (>26000), aşı ve enfeksiyon öyküsünün olmamasının hastalığın kronikleşmesinde etkili olduğu, yalnızca steroid ya da IvIg tedavisi verilen hastaların kombine tedavi alanlara göre daha fazla tam remisyona girdiği görülmektedir. Anahtar Kelimeler: ITP, Çocukluk çağı, İmmün trombositopenik purpura, prognoz.
Retrospective Analysis of Patients with Idiopathic Thrombocytopenic Purpura Followed in the Department of Pediatric Hematology Oncology, Faculty of Medicine, İnönü University Aim: The aim of this study was to retrospectively examine the files of ITP patients, investigating their demographic information and clinical characteristics at the time of admission, comparing the effectiveness of various treatment options, and determining the clinical prognosis of the patients. Material and Method: The population of this research consists of ITP patients diagnosed at İnönü University Turgut Özal Medical Center between 2010 and 2020. The sample of the study was determined to be at least 120 ITP patients, comprising 60 chronic, 60 acute, and persistent cases, based on a power analysis. Data were obtained by scanning patient files. Percentages, frequencies, Chi-square analysis, and t-tests for dependent and independent groups were employed in the evaluation of the collected data. Results: Of the 120 patients included in the study, 53.33% were female and 46.67% were male, with a mean age of diagnosis of 6.88±4.70 years and a mean followup duration of 3.63±3.00 years. The lowest mean age was observed in the persistent ITP group, while the highest mean age was in the chronic ITP group. Most patients were diagnosed during the summer season. The female-to-male ratio was 1.04 in the acute ITP group, 0.29 in the persistent ITP group, and 1.50 in the chronic ITP group. The mean platelet count at the time of diagnosis was 18915±23133/mm3. The most common presenting complaint was skin bruising, and the most common physical examination finding upon presentation was ecchymosis. Infection was present in 52.94% of patients, while 5.00% had a history of vaccination. Bone marrow aspiration was performed in 95.00% of patients, with increased megakaryocytes observed in 76.32%. All patients in the observation-only group initially entered spontaneous remission, with 33.33% progressing to chronicity during follow-up. Patients who received standard-dose methylprednisolone as initial treatment all showed a chronic course. A significant relationship was found between the treatments administered and the responses obtained. 94.12% of acute ITP patients achieved complete remission with initial treatment. All persistent ITP patients achieved complete remission, while 58.33% of chronic ITP patients achieved partial remission and 35.00% achieved complete remission. Across all 120 patients, 3.33% were unresponsive, 29.17% showed partial response, and 67.50% showed complete response. Conclusion: In children with ITP, it is observed that late age at diagnosis, high platelet count (>26000) at presentation, absence of vaccination and infection history are effective in the chronicity of the disease, and patients who receive only steroid or IVIg treatment achieve complete remission more frequently compared to those receiving combination therapy. Keywords: ITP, Childhood, Immune thrombocytopenic purpura, prognosis.
Retrospective Analysis of Patients with Idiopathic Thrombocytopenic Purpura Followed in the Department of Pediatric Hematology Oncology, Faculty of Medicine, İnönü University Aim: The aim of this study was to retrospectively examine the files of ITP patients, investigating their demographic information and clinical characteristics at the time of admission, comparing the effectiveness of various treatment options, and determining the clinical prognosis of the patients. Material and Method: The population of this research consists of ITP patients diagnosed at İnönü University Turgut Özal Medical Center between 2010 and 2020. The sample of the study was determined to be at least 120 ITP patients, comprising 60 chronic, 60 acute, and persistent cases, based on a power analysis. Data were obtained by scanning patient files. Percentages, frequencies, Chi-square analysis, and t-tests for dependent and independent groups were employed in the evaluation of the collected data. Results: Of the 120 patients included in the study, 53.33% were female and 46.67% were male, with a mean age of diagnosis of 6.88±4.70 years and a mean followup duration of 3.63±3.00 years. The lowest mean age was observed in the persistent ITP group, while the highest mean age was in the chronic ITP group. Most patients were diagnosed during the summer season. The female-to-male ratio was 1.04 in the acute ITP group, 0.29 in the persistent ITP group, and 1.50 in the chronic ITP group. The mean platelet count at the time of diagnosis was 18915±23133/mm3. The most common presenting complaint was skin bruising, and the most common physical examination finding upon presentation was ecchymosis. Infection was present in 52.94% of patients, while 5.00% had a history of vaccination. Bone marrow aspiration was performed in 95.00% of patients, with increased megakaryocytes observed in 76.32%. All patients in the observation-only group initially entered spontaneous remission, with 33.33% progressing to chronicity during follow-up. Patients who received standard-dose methylprednisolone as initial treatment all showed a chronic course. A significant relationship was found between the treatments administered and the responses obtained. 94.12% of acute ITP patients achieved complete remission with initial treatment. All persistent ITP patients achieved complete remission, while 58.33% of chronic ITP patients achieved partial remission and 35.00% achieved complete remission. Across all 120 patients, 3.33% were unresponsive, 29.17% showed partial response, and 67.50% showed complete response. Conclusion: In children with ITP, it is observed that late age at diagnosis, high platelet count (>26000) at presentation, absence of vaccination and infection history are effective in the chronicity of the disease, and patients who receive only steroid or IVIg treatment achieve complete remission more frequently compared to those receiving combination therapy. Keywords: ITP, Childhood, Immune thrombocytopenic purpura, prognosis.
Açıklama
Anahtar Kelimeler
Hematoloji, Hematology
