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Fatigue in children and adolescents with immune thrombocytopenia

Rachael F Grace1, Robert J Klaassen2, Kristin A Shimano3

  • 1Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA.

British Journal of Haematology
|June 6, 2020
PubMed

Insights

Children and adolescents with immune thrombocytopenia (ITP) experience significant fatigue, which improves with ITP-directed treatment. Fatigue impacts quality of life but is not linked to bleeding or platelet count.

Area of Science:

  • Pediatric Hematology
  • Autoimmune Diseases
  • Quality of Life Research

Background:

  • Immune thrombocytopenia (ITP) is an autoimmune disorder causing low platelet counts and bleeding risk.
  • Fatigue is a common but poorly understood symptom impacting health-related quality of life (HRQoL) in ITP patients.
  • Pediatric ITP significantly affects children's and adolescents' daily lives and well-being.

Purpose of the Study:

  • To assess fatigue levels in children and adolescents with ITP receiving second-line therapies.
  • To investigate the correlation between fatigue and clinical factors like age, gender, ITP duration, bleeding, and platelet count.
  • To evaluate the impact of ITP-directed treatment on fatigue and HRQoL.

Main Methods:

  • An observational cohort study involving 120 children and adolescents with ITP.
  • Utilized the Hockenberry Fatigue Scale to measure fatigue severity.
  • Assessed fatigue at baseline, 1 month, and 12 months after initiating second-line treatments.
  • Correlated fatigue scores with the Kids ITP Tool (HRQoL), bleeding symptoms, and platelet counts.

Main Results:

  • High prevalence of moderate-to-severe fatigue reported by 54% of children and 62% of adolescents.
  • Adolescents with newly diagnosed/persistent ITP showed higher fatigue scores than chronic ITP patients.
  • Fatigue significantly improved within 1 month and remained improved at 12 months post-treatment.
  • Fatigue correlated with general HRQoL but not with bleeding symptoms or platelet counts.

Conclusions:

  • Fatigue is a prevalent issue in pediatric ITP, independent of bleeding or platelet levels.
  • ITP-directed treatment can effectively alleviate fatigue in children and adolescents.
  • Addressing fatigue is crucial for improving the overall quality of life in pediatric ITP patients.

Keywords:
fatigueimmune thrombocytopeniaquality of liferituximabthrombopoietin receptor agonists

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