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Review
. 2018 Nov 27:9:369-384.
doi: 10.2147/PROM.S140932. eCollection 2018.

Immune thrombocytopenia: improving quality of life and patient outcomes

Patrick Trotter  1   2 , Quentin A Hill  3
Affiliations
Review

Immune thrombocytopenia: improving quality of life and patient outcomes

Patrick Trotter et al. Patient Relat Outcome Meas. .

Abstract

Immune thrombocytopenia (ITP) is an immune-mediated disorder characterized by a reduced platelet count and patients may develop bruising or mucosal bleeding. Since 2003, generic health-related quality of life (HRQoL) measures have been applied and ITP-specific measures developed, alongside trials of novel therapeutic agents. These have identified significant morbidity in patients with ITP, including fatigue, fear of bleeding and a negative impact on role, social and work activities. This review critically evaluates HRQoL data in adults and children with ITP. It also considers the impact of treatment and how patient-reported outcomes might be applied to care to optimize patients' quality of life.

Keywords: ITP-PAQ; KIT; SF-36; bleeding; depression; eltrombopag; fatigue; immune thrombocytopenia; quality of life; romiplostim.

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Conflict of interest statement

Disclosure PT has no competing interests. QAH has received speaker and advisory fees from Novartis and research support from the ITP Support Association. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Conceptual model for health-related quality of life in patients with ITP. Note: Reproduced from Mathias SD, Gao SK, Miller KL, et al. Impact of chronic Immune Thrombocytopenic Purpura (ITP) on health-related quality of life: a conceptual model starting with the patient perspective. Health Qual Life Outcomes. 2008;6:13. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode. Abbreviation: ITP, immune thrombocytopenia.
Figure 2
Figure 2
Model of the pathogenesis of ITP-associated fatigue. Notes: *T cells can attack platelets directly, secrete proinflammatory cytokines and drive formation of autoreactive B cells. This results in antibody- and complement-mediated platelet destruction. Platelet microparticles are prothrombotic and able to activate the proinflammatory complement pathway. Reproduced from Hill QA, Newland AC. Fatigue in immune thrombocytopenia. Br J Haematol. 2015;170(2):141–149 with permission from the publisher, John Wiley and Sons. © 2015 John Wiley & Sons Ltd. Abbreviations: ITP, immune thrombocytopenia; 2ry, secondary; B cell, autoantibody producing B lymphocytes; T cell (Th1), T lymphocyte with a T helper 1 polarization; TNF-α, tumor necrosis factor-α; IFN-γ, interferon-γ; MP, microparticle; CNS, central nervous system.
See this image and copyright information in PMC

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