Prognosis of adult primary immune thrombocytopenia and its predicting factors

Objective To analyze the autoantibody expression and prognostic factors in adults primary immune thrombocytopenia (ITP). Methods Clinical data about 163 patients with ITP admitted to the hematology ward of the affiliated hospital of Southwest Medical University from January 2014 to March 2019 were retrospectively analyzed.The patients were followed up,and the autoantibody expression and factors affecting the prognosis were analyzed. Results Of the 163 cases,114 patients were cured and 49 cases were not cured.Positive expression of autoantibody was found in 48 cases,and the positive rate was higher in female (36.3%,37/102) than that of male (18.0%,11/61),and it was also higher in patients aged≥60 years (41.9%,18/43) than that in patients<60 years (25%,30/120),and these differences were statistically significant (P<0.05,respectively).Univariate analysis showed that initial platelet counts,bleeding score,autoantibody and immunoglobulin treatment were associated with the prognosis of ITP (all P<0.05).Multivariate analysis showed that positive expression of autoantibody (OR,0.142;95% CI,0.060-0.336),lower bleeding score (OR,8.062;95% CI,2.429-26.763) and immunoglobulin treatment (OR,6.235;95% CI,1.905-20.402) were independent factors affecting prognosis (all P<0.01). Conclusion The autoantibody positive rate in adults with primary immune thrombocytopenia is higher in women than that in men,and it increases with age.Autoantibody,immunoglobulin treatment and bleeding score are independent factors affecting the prognosis of adults with primary immune thrombocytopenia.