Survival is reduced for patients with both primary and secondary immune thrombocytopenia (ITP) compared to the general population, according to a study published in Transfusion

While survival was reduced for these patients, data seemed to show an improvement in the prognosis for patients with primary ITP over the years, the researchers noted. Secondary ITP, on the other hand, showed a reduction in 5-year survival, they added.

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Compared to matched comparators, patients with primary ITP had a median survival rate that was 5.1 years lower (22.1 years compared to 27.1 years), while patients with secondary ITP had a median survival that was reduced by 11.1 years (13.4 years compared to 24.5 years).

The 5-year survival of patients with primary ITP was 69% between 1980 and 1989 which increased to 80% between 2010 and 2016. This was in comparison to an increase from 88% to 90% in comparators during the same time windows. For patients with secondary ITP, the 5-year survival decreased from 100% in 1980 to 1989 to only 64% between 2010 and 2016. The comparator group had a decrease from 95% in 1989 to 1998 down to 89% in 2010 to 2016.

“These novel data show that survival is reduced, but seems to be improving over the past decades for patients with chronic ITP, and that comorbidity and [secondary ITP] is associated with poorer survival,” the authors said.

In both primary and secondary patients with ITP, deaths from bleeding, infection, and hematological cancer were relatively higher than in comparators. In the first years after diagnosis with chronic ITP, deaths from cardiovascular disease and solid cancer were also more common. The difference between the patients with ITP and comparators reduced over time, however.

A total of 1762 patients with primary ITP, 128 patients with secondary ITP, and 74,781 age-sex-matched comparators were included in the study. The patients were identified through the use of the nationwide Danish health registries. Of the patients with secondary ITP, the most frequent cause was from autoimmune disease.


Mannering N, Hansen DL, Pottegård A, Frederiksen H. Survival in adult patients with chronic primary and secondary immune thrombocytopenia: a population-based study. Transfusion. Published online January 5, 2023. doi:10.1111/trf.17212