ITP Patients in the Asia Pacific: Are They Different?
Bibliographic record
Abstract
Background Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by auto-antibody induced platelet (PLT) destruction and reduced PLT production, leading to a low PLT count. The availability of robust epidemiological and clinical data on ITP in regions outside Europe and the United States is limited. The International ITP Registry is a prospective cohort study which seeks to collect epidemiological and clinical data of recently diagnosed primary ITP adult patients, predominantly from the Asia-Pacific region. The International Registry has been established for > 6 years. Aims To contrast and compare the International ITP Registry population with the Intercontinental Cooperative Immune Thrombocytopaenia Study Group Pediatric and Adult Intercontinental Registry on Chronic ITP (PARC-ITP Registry) adult population. The PARC - ITP Registry was selected as it represents a prospective cohort including newly diagnosed ITP patients, with a comparably sized adult cohort which is well established (>5 years) across the regions in which epidemiological data is already available1. Method Clinical and laboratory data from the International ITP Registry 2016 data analysis were compared with clinical and laboratory data reported for adults enrolled in the PARC-ITP registry. Results The PARC Registry had 340 adult patients enrolled in 31 countries across Europe, Canada, United States, Latin America, the Middle East, and Asia. As at 31 August 2016 514 patients had data available for the International ITP Registry from 44 sites across 10 countries. Patient characteristics are presented in Table 1. The International ITP Registry has a predominance of patients of Asian origin whereas the PARC- ITP Registry population is principally Caucasian (55% v 63%). A female predominance is seen in both cohorts. Comorbidities are reported more often in the International Registry group (34% vs 30% in PARC). Hypertension is the most often reported comorbidity in both groups. Of the comorbidities related to ITP diagnosis that are available for comparison, diabetes occurs more often in the International Registry group and gastrointestinal disease is reported at similar rates in both groups (Table 1). Mean PLT count at baseline was 32 x 109/L (range 0-99 x 109/L) in the International Registry group and 25.4 x 109/L (range 0-133 x 109/L) in the PARC Registry adults. Corticosteroids are the most frequently used first-line treatment in both groups - 76% in the International Registry and 59% in the PARC-ITP Registry adults. IVIg is used in both populations at much lower rates - 26 % in the International Registry and 6% in the PARC-ITP Registry adults. Splenectomy is uncommon, with 40 patients in our group having splenectomy, splenectomy is not reported on in the PARC-ITP Registry publication. TPO-receptor agonist use is reported in the International Registry group (n = 48) but not reported on in the PARC-ITP Registry group. Anti-D is reported both groups at rates Clinical signs of bleeding were assessed by location in both Registries. The International Registry also records severity of bleeding. Bleeding at any site was seen in 39% of patients in the International Registry whereas PARC -ITP Registry reports manifestations of bleeding in 69% of adults. Summary/Conclusion Comparative data showed similarities in gender distribution, presenting platelet counts, and diagnostic testing, whereas differences occurred in ethnicity, co-morbidity, bleeding, and first and second line therapies. References Kuhne T, et al on behalf of the Intercontinental Cooperative ITP Study Group. Newly diagnosed immune thrombocytopenia in children and adults: a comparative prospective observational registry of the Intercontinental Cooperative Immune Thrombocytopenia Study Group. Haematologica 2011;96(12):1831-1837. doi:10.3324/haematol.2011.050799 Disclosures Lee: Novartis: Consultancy, Membership on an entity9s Board of Directors or advisory committees, Other: Member of advisory Boards for Novartis on Revolade ;involved in the Novartis sponsored Phase IV multicenter, observational study in Chronic Immune Thrombocytopenia patients on Revolade treatment in emerging markets (CITE Study), Research Funding. Ilhan: Novartis: Consultancy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".