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Minerva Pediatr. 2014 Dec 12. [Epub ahead of print]

Initial lymphocyte count in patients with acute immune thrombocytopenic purpura: Can it predict persistence of the disease?

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Assistant Professor in Pediatrics, Pediatric Hematolosit and Oncologist, OncoPathologyResearch Center, AliAsghar Children Hospital, Iran University of Medical Sciences, Islamic Republique of Iran -



It has been suggested that initial total leukocyte count (TLC) and initial absolute lymphocyte count (ALC) can predict development of chronic/persistent disease in children with acute immune thrombocytopenia purpura (ITP). However, this association has not confirmed by other studies. This study aims to investigate probable association between initial TLC and ALC with development of chronic/persistent ITP.


The present study was carried out at Aliasghar children hospital and all children with diagnosis of acute ITP were identified from 2001 to 2008. Data gathered retrospectively by reviewing patients' records. Initial TLC and ALC were compared between recovered patients and those with chronic/persistent ITP.


116 children with diagnosis of acute ITP were included in the study. Respectively, 59 (50.8%) and 57 (49.2%) cases were categorized in recovered (group 1) and chronic/persistent (group 2) ITP. Mean TLC was 8470±342 Cell/L in study patients, 8644±546 Cell/L in group 1 and 8290±412 Cell/L in group 2 which was not statistically significant (p=0.60). Mean ALC was 4176± 189 Cell/L. Mean lymphocyte count in group 1 was significantly higher at 4542± 273 Cell/L in group 1 compared to group 2 at 3797±253 Cell/L (p=0.04). Logistic regression analysis showed that ALC < 5000 Cell/L is a predictor of chronic/persistent ITP (Odds ratio: 2.757, 95% CI 1.215 6.260, p=0.015). Sensitivity, positive and negative predicative values for ALC of <5000 Cell/L were calculated as 80%, 57%, and 68%, respectively.


Our findings indicated that initial ALC but not TLC is a predictor of chronic/persistent ITP in children with acute ITP. Further studies are recommended to explore underlying mechanisms that a lower initial ALC contributes to development of chronic/persistent ITP.


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