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Risks and outcomes of hospitalizations in patients with chronic lymphocytic leukemia admitted with immune thrombocytopenia: an analysis of the National Inpatient Sample Database

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Abstract

Immune thrombocytopenia (ITP) is a known autoimmune complication of chronic lymphocytic leukemia (CLL). Currently, there is limited data regarding the risk CLL confers on hospitalization outcomes in patients admitted with ITP.The National Inpatient Sample (NIS) database was queried using the International Classification of Diseases (ICD) codes to identify hospitalizations for ITP and then subclassified the data into hospitalizations with and without CLL. A multivariate logistic regression was designed to account for patient characteristics and comorbidities. The primary outcome was all-cause mortality. Secondary outcomes included major bleeding, gastrointestinal bleeding, intracranial bleeding, and the need for platelet transfusions, intravenous immunoglobulin, and splenectomy. Among 662,171 cases of ITP between 2005 and 2019, 15,672 had concurrent CLL. CLL patients were significantly older and had more comorbidities compared to patients without CLL. Multivariate analysis revealed CLL patients with ITP had a risk of all-cause mortality (odds ratio: 1.28, 95% CI: 1.19–1.37; p < 0.01). CLL patients also had a higher risk of complications, second-line ITP treatments, blood transfusions, and bleeding, with the exception of intracranial hemorrhage. Our study suggests CLL is an independent risk factor for increased morbidity and mortality among hospitalized patients with ITP. Prospective studies are needed to determine if refractoriness to conventional treatments for ITP can account these results.

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Authors and Affiliations

  1. Hematology/Oncology, University of South Florida, Tampa, FL, USA

    Mohammad Ammad Ud Din & Moazzam Shahzad

  2. Hematology/Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Mohammad Ammad Ud Din & Moazzam Shahzad

  3. Internal Medicine, Rochester General Hospital, Rochester, NY, USA

    Amir Mahmud, Mariam Mostafa & Hania Liaqat

  4. Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Javier Pinilla-Ibarz & Michael Jaglal

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  1. Mohammad Ammad Ud Din
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  2. Amir Mahmud
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Correspondence to Mohammad Ammad Ud Din.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

Javier Pinilla-Ibarz received research grant from SecuraBio and consultancy fee from AstraZeneca, AbbVie, Pharmacyclics, Janssen Pharmaceuticals. Michael Jaglal received consultancy fee from Novartis. Mohammad Ammad Ud Din, Amir Mahmud, Mariam Mostafa, Moazzam Shahzad, and Hania Liaqat declare that they have no conflict of interest.

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Ammad Ud Din, M., Mahmud, A., Mostafa, M. et al. Risks and outcomes of hospitalizations in patients with chronic lymphocytic leukemia admitted with immune thrombocytopenia: an analysis of the National Inpatient Sample Database. Ann Hematol 102, 889–895 (2023). https://doi.org/10.1007/s00277-023-05133-5

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  • DOI: https://doi.org/10.1007/s00277-023-05133-5

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