Early response and long‐term prognosis of paediatric ITP: Exploration of future management strategies

Immune thrombocytopenia (ITP) is the most common immunological haemorrhagic disease in childhood. Our retrospective study analysed hospitalized paediatric ITP patients to identify determinants of early treatment response and long-term clinical outcomes. The study found that younger children had a higher 7-day complete response (CR) rate and were more likely to achieve CR in the early stages (p = 0.003, hazard ratio = 0.960 [0.934-0.986]). There was no difference in early partial response or CR rates between subgroups of intravenous immunoglobulin at different doses (p > 0.05). Age was identified as an independent factor affecting long-term prognosis, with older children experiencing a longer duration of illness (p < 0.001, odds ratio = 1.225 [1.143-1.309]). The long-term prognosis was not influenced by early treatment response. Despite this, current first-line treatments for children cannot prevent disease recurrence or improve long-term outcomes. Whether treatment strategies based on risk stratification and early combination of second-line treatments can decrease glucocorticoid use, reduce the likelihood of chronic ITP, improve quality of life and optimize long-term prognosis remains to be determined. The optimization of treatment regimens based on risk stratification warrants further investigation.