Real-world, single-center experience of SARS-CoV-2 vaccination in immune thrombocytopenia.
COVID-19
immune thrombocytopenia
platelets
relapse
vaccination
Journal
Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
12
03
2022
received:
05
10
2021
accepted:
15
03
2022
pubmed:
22
3
2022
medline:
25
5
2022
entrez:
21
3
2022
Statut:
ppublish
Résumé
Immune thrombocytopenic purpura (ITP) relapse following vaccination remains poorly reported in the adult population. This report details real world data from the largest single-center cohort of ITP relapse following severe acute respiratory syndrome (SARS-CoV-2) vaccination. The vaccination status of 294 patients under active follow-up was reviewed. A total of 17 patients were identified resulting in an incidence of ITP relapse following SARS-CoV-2 vaccination in this cohort of 6.6% and an incidence of newly diagnosed ITP following SARS-CoV-2 vaccination of 1.4%. Patients were noted to develop marked deviation of platelet count from baseline following vaccination (P =< .0001). Fourteen patients had a prior diagnosis of ITP and median follow-up following diagnosis was 4 years (range 0-45 years). Days from vaccination to presentation ranged from 2-42 (median 14) and the follow-up period was 34 weeks. Fifteen patients (88%) presented with symptoms and all 17 patients developed symptoms during the follow-up period. Nine patients (53%) received a second dose of vaccine during the follow-up period with seven patients (78%) requiring therapeutic support to facilitate second vaccination. Decision to treat patients was multi-factorial and aimed at decreasing bleeding symptoms and obtaining a platelet count >30 × 10 Vaccination of ITP patients continues to have important clinical benefit; however, recommendations for patients who relapse remain lacking. This report outlines the real-world patient outcomes in the era of widespread SARS-CoV-2 vaccination.
Sections du résumé
BACKGROUND
Immune thrombocytopenic purpura (ITP) relapse following vaccination remains poorly reported in the adult population.
OBJECTIVES
This report details real world data from the largest single-center cohort of ITP relapse following severe acute respiratory syndrome (SARS-CoV-2) vaccination.
METHODS
The vaccination status of 294 patients under active follow-up was reviewed. A total of 17 patients were identified resulting in an incidence of ITP relapse following SARS-CoV-2 vaccination in this cohort of 6.6% and an incidence of newly diagnosed ITP following SARS-CoV-2 vaccination of 1.4%.
RESULTS
Patients were noted to develop marked deviation of platelet count from baseline following vaccination (P =< .0001). Fourteen patients had a prior diagnosis of ITP and median follow-up following diagnosis was 4 years (range 0-45 years). Days from vaccination to presentation ranged from 2-42 (median 14) and the follow-up period was 34 weeks. Fifteen patients (88%) presented with symptoms and all 17 patients developed symptoms during the follow-up period. Nine patients (53%) received a second dose of vaccine during the follow-up period with seven patients (78%) requiring therapeutic support to facilitate second vaccination. Decision to treat patients was multi-factorial and aimed at decreasing bleeding symptoms and obtaining a platelet count >30 × 10
CONCLUSION
Vaccination of ITP patients continues to have important clinical benefit; however, recommendations for patients who relapse remain lacking. This report outlines the real-world patient outcomes in the era of widespread SARS-CoV-2 vaccination.
Identifiants
pubmed: 35313390
doi: 10.1111/jth.15704
pmc: PMC9115165
pii: S1538-7836(22)00198-2
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1476-1484Informations de copyright
© 2022 International Society on Thrombosis and Haemostasis.
Références
N Engl J Med. 2020 Jun 25;382(26):2534-2543
pubmed: 32459916
Br J Haematol. 2021 Jun;193(6):1093-1095
pubmed: 33855698
Lancet. 2021 Jan 9;397(10269):99-111
pubmed: 33306989
Eur J Haematol. 2020 Sep;105(3):344-351
pubmed: 32474953
N Engl J Med. 2019 Sep 5;381(10):945-955
pubmed: 31483965
Blood. 2010 Jan 14;115(2):168-86
pubmed: 19846889
Blood. 2009 Mar 12;113(11):2386-93
pubmed: 19005182
N Engl J Med. 2021 Jun 10;384(23):2202-2211
pubmed: 33861525
N Engl J Med. 2021 Feb 4;384(5):403-416
pubmed: 33378609
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Blood. 2009 Jun 25;113(26):6511-21
pubmed: 19395674
Am J Hematol. 2020 Dec;95(12):1578-1589
pubmed: 32857878
Br J Haematol. 2021 Dec;195(5):703-705
pubmed: 34467525
JAMA Intern Med. 2020 Oct 1;180(10):1345-1355
pubmed: 32667669
Pediatrics. 2008 Mar;121(3):e687-92
pubmed: 18310189
Br J Haematol. 2021 Aug;194(3):547-549
pubmed: 33934330
Curr Med Res Opin. 2012 Jan;28(1):79-87
pubmed: 22117897
Nat Med. 2021 Jul;27(7):1290-1297
pubmed: 34108714
Am J Hematol. 2021 Nov 1;96(11):E413-E416
pubmed: 34478178
Br J Clin Pharmacol. 2003 Jan;55(1):107-11
pubmed: 12534647
Br J Haematol. 2021 Nov;195(3):365-370
pubmed: 34075578
Blood. 2022 Mar 10;139(10):1564-1574
pubmed: 34587251
Am J Hematol. 2021 May 1;96(5):534-537
pubmed: 33606296
Br J Haematol. 2017 May;177(3):475-480
pubmed: 28295201
Br J Haematol. 2020 Jun;189(6):1038-1043
pubmed: 32374026
Blood Adv. 2019 Nov 26;3(22):3780-3817
pubmed: 31770441
N Engl J Med. 2020 Dec 31;383(27):2603-2615
pubmed: 33301246