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Favorable prognosis of vaccine-associated immune thrombocytopenia in children is correlated with young age at vaccination: Retrospective survey of a nationwide disease registry

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Abstract

Childhood vaccine-associated immune thrombocytopenia (ITP) has a mostly favorable prognosis. To identify factors associated with prognosis, a retrospective survey was conducted with children with ITP who were registered in the Japanese Society of Pediatric Hematology/Oncology registry from 2008 to 2011. A total of 477 patients were categorized into four groups by event preceding ITP onset: vaccine-precedence (VP; n = 43), vaccine/infection-precedence (VIP; n = 34), infection-precedence (IP; n = 162), and no vaccine/infection-precedence (NVI; n = 238). Compared to IP and NVI, VP and VIP were significantly younger at diagnosis, with the age distribution peaking at infancy, and more frequently had favorable prognosis. Time to platelet recovery to 100 × 103/µL was significantly faster for VP and VIP than NVI. Multivariate Cox regression analysis with sex, age at diagnosis, infection-precedence, and vaccine-precedence as variables revealed age < 36 months (HR 0.992, 95% CI 0.989–0.995; p < 0.001) and male sex (HR 0.770, 95% CI 0.623–0.952; p = 0.015) as associated factors, but not infection-precedence (p = 0.149) or vaccine-precedence (p = 0.650). In subgroup analysis in patients < 36 months, age at diagnosis (p < 0.001) was the only associated factor. Favorable prognosis of childhood vaccine-associated ITP is correlated with young age at vaccination, but not with vaccination itself.

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Acknowledgements

We extend our sincere condolences to family, friends, and colleagues of Dr. Shigeru Ota, who passed away on February 20, 2019, at the age of 69, without seeing the completion of this dissertation. We extend our sincere thanks to Ms. Michiyo Kanda for her efforts in data processing.

Author information

Authors and Affiliations

  1. Department of Clinical Genetics, Aomori Prefectural Central Hospital, Aomori, Japan

    Junichi Kitazawa

  2. Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan

    Hisaya Nakadate

  3. Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, Kobe, Japan

    Kousaku Matsubara

  4. Japanese Red Cross Nara Blood Center, Nara, Japan

    Yukihiro Takahashi

  5. Division of Hematology, National Center for Child Health and Development, Tokyo, Japan

    Akira Ishiguro

  6. Showa University Research Administration Center, Showa University, Tokyo, Japan

    Eisuke Inoue

  7. Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan

    Yoji Sasahara

  8. Fujisawa Children’s Clinic, Tokyo, Japan

    Koji Fujisawa

  9. Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Naoko Maeda

  10. Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan

    Toshiaki Oka

  11. Imabari City Medical Association General Hospital, Ehime, Japan

    Eiichi Ishii

  12. Department of Hematology and Oncology, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai, Miyagi, 989-3126, Japan

    Masue Imaizumi

Authors
  1. Junichi Kitazawa
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  2. Hisaya Nakadate
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  3. Kousaku Matsubara
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  4. Yukihiro Takahashi
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  5. Akira Ishiguro
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  6. Eisuke Inoue
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  7. Yoji Sasahara
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  8. Koji Fujisawa
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  9. Naoko Maeda
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  10. Toshiaki Oka
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  11. Eiichi Ishii
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  12. Masue Imaizumi
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Consortia

Platelet Committee of the Japanese Society of Pediatric Hematology/Oncology

Contributions

JK conceived the study, analyzed the data, and helped write the manuscript. HN carried out data collection and data cleaning. KM, YT, AI, YS, KF, NM, TO, and EI wrote the manuscript. EI analyzed the platelet recovery data statistically. MI conceived and designed the study, analyzed the data further, and mainly wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masue Imaizumi.

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Kitazawa, J., Nakadate, H., Matsubara, K. et al. Favorable prognosis of vaccine-associated immune thrombocytopenia in children is correlated with young age at vaccination: Retrospective survey of a nationwide disease registry. Int J Hematol 115, 114–122 (2022). https://doi.org/10.1007/s12185-021-03230-7

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  • DOI: https://doi.org/10.1007/s12185-021-03230-7

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