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Immune thrombotic thrombocytopenic purpura in older patients: prognosis and long-term survival

dc.rights.licenseopenen_US
dc.contributor.authorPREVEL, R.
dc.contributor.authorROUBAUD-BAUDRON, C.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGOURLAIN, Samuel
dc.contributor.authorJAMME, M.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorPERES, Karine
dc.contributor.authorBENHAMOU, Y.
dc.contributor.authorGALICIER, L.
dc.contributor.authorAZOULAY, E.
dc.contributor.authorPOULLIN, P.
dc.contributor.authorPROVOT, F.
dc.contributor.authorMAURY, E.
dc.contributor.authorPRESNE, C.
dc.contributor.authorHAMIDOU, M.
dc.contributor.authorSAHEB, S.
dc.contributor.authorWYNCKEL, A.
dc.contributor.authorSERVAIS, A.
dc.contributor.authorGIRAULT, S.
dc.contributor.authorDELMAS, Y.
dc.contributor.authorCHATELET, V.
dc.contributor.authorAUGUSTO, J. F.
dc.contributor.authorMOUSSON, C.
dc.contributor.authorPEREZ, P.
dc.contributor.authorHALIMI, J. M.
dc.contributor.authorKANOUNI, T.
dc.contributor.authorLAUTRETTE, A.
dc.contributor.authorCHARVET-RUMPLER, A.
dc.contributor.authorDELIGNY, C.
dc.contributor.authorCHAUVEAU, D.
dc.contributor.authorVEYRADIER, A.
dc.contributor.authorCOPPO, P.
dc.date.accessioned2020-07-10T06:20:24Z
dc.date.available2020-07-10T06:20:24Z
dc.date.issued2019-12-12
dc.identifier.issn1528-0020 (Electronic) 0006-4971 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/10386
dc.description.abstractEnOlder age is associated with increased mortality in immune thrombotic thrombocytopenic purpura (iTTP). Yet, data are scarce regarding iTTP occurring among older patients. To assess clinical features and long-term impact of iTTP on mortality in older patients (>60 years old), characteristics and prognoses of adult iTTP patients enrolled in the French Reference Center for Thrombotic Microangiopathies registry between 2000 and 2016 were described according to age (<60 years old or >/=60 years old). Long-term mortality of iTTP older survivors was compared with that of non-iTTP geriatric subjects. Comparing, respectively, older iTTP patients (N = 71) with younger patients (N = 340), time from hospital admission to diagnosis was longer (P < .0001); at diagnosis, delirium (P = .034), behavior impairment (P = .045), renal involvement (P < .0001), and elevated troponin level (P = .025) were more important whereas cytopenias were less profound (platelet count, 22 x 103/mm3 [9-57] vs 13 x 103/mm3 [9-21], respectively [P = .002]; hemoglobin level, 9 g/dL [8-11] vs 8 g/dL [7-10], respectively [P = .0007]). Short- and mid-term mortalities were higher (P < .0001) and increased for every 10 years of age range. Age >/=60 years, cardiac involvement, increased plasma creatinine level, and total plasma exchange volume were independently associated with 1-month mortality. Compared with a non-iTTP geriatric population, older survivors showed an increased long-term mortality (hazard ratio = 3.44; P < .001). In conclusion, older iTTP patients have atypical neurological presentation delaying the diagnosis. Age negatively impacts short-term but also long-term mortality.
dc.language.isoENen_US
dc.subject.enSEPIA
dc.title.enImmune thrombotic thrombocytopenic purpura in older patients: prognosis and long-term survival
dc.title.alternativeBlooden_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1182/blood.2019000748
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed31530564en_US
bordeaux.journalBlooden_US
bordeaux.page2209-2217en_US
bordeaux.volume134en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue24en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03162621
hal.version1
hal.date.transferred2021-03-12T10:52:48Z
hal.exporttrue
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