Initial lymphocyte count's predictive value in immune thrombocytopenic purpura

Abstract

ObjectiveThe objective of this study was to examine whether absolute lymphocyte count (ALC) at diagnosis correlates with the course of immune thrombocytopenia purpura (ITP) and could be considered as a prognostic factor in adults and children.Patients and methodsA retrospective study of 250 patients diagnosed as having primary ITP, including 150 adult patients and 100 children, was conducted between July 2013 and July 2018 at Hematology Department and outpatient clinic.ResultsA highly significant decrease in mean ALC was noted in chronic ITP adult cases (1.55 ± 0.69) compared with newly diagnosed ITP cases (2.99 ± 1.23) (P = 0.000). Moreover, ALC less than 2.050/mm3 was associated with a significant risk for developing chronic ITP (P = 0.000), as only eight (26.7%) cases with ALC less than 2050/mm3 developed newly diagnosed ITP, whereas 97 cases with ALC less than 2050/mm3 (80.8%) developed chronic ITP. Thus ALC less than 2050/mm3 is considered a significant risk factor for developing chronic ITP in adults. In contrast, mean ALC in pediatric cases showed a significant decrease in chronic ITP cases (2.55 ± 1.01) compared with newly diagnosed cases (3.68 ± 1.34) (P = 0.000). Moreover, ALC less than 2050/mm3 was associated with a significant risk for developing chronic ITP (P = 0.001), as only one case less than 2050/mm3 (2.5%) developed newly diagnosed ITP, whereas 17 cases less than 2050/mm3 (28.3%) developed chronic ITP.ConclusionALCs at diagnosis is statistically a strong predictor of the development of chronic ITP in adult and pediatric patients. ALC at cutoff less than 2050/mm3 is considered a significant risk factor for developing chronic ITP in adults and pediatric cases (P = 0.000 and 0.001, respectively).