P. Philippet MD

Refractory immune thrombocytopenic purpura in a child with vitamin D deficiency

SUMMARY

Immune thrombocytopenic purpura is an isolated thrombocytopenia consisting of premature platelet destruction mediated by self-reacting antibodies and an impaired platelet production. In children, most of the cases resolve spontaneously within six months. Several studies have shown a high incidence of vitamin D deficiency in auto-immune disorders, including immune thrombocytopenic purpura. We report the clinical history of an eight-year-old boy who presented with refractory immune thrombocytopenic purpura and major vitamin D deficiency. Supplementation in vitamin D was followed by a rapid normalisation of thrombocytosis. After six months of evolution, the child developed a relapse of immune thrombocytopenic purpura concomitant with a decrease of his serum level of vitamin D. Treatment with vitamin D associated with dapsone resulted in a prolonged remission. After thirteen months, dapsone treatment was stopped and the platelet count remained normal. This article reviews the approach of refractory immune thrombocytopenic purpura in children and discusses the potential interest of vitamin D in this disease.

(BELG J HEMATOL 2018;9(2):64–7.)

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Minimal residual disease quantification by PCR in childhood acute lymphoblastic leukaemia

Summary

In Belgium approximately 70 children are diagnosed with acute lymphoblastic leukaemia annually. For these children, the monitoring of minimal residual disease has an important prognostic value. The level of minimal residual disease during the first three months of therapy is used to recognise subgroups that differ substantially in outcome. Two techniques are used for minimal residual disease monitoring: the Genescan method and the allele specific oligonucleotide polymerase chain reaction. The Genescan method is a less sensitive method (10⁻³) but is fast and less expensive. The allele specific oligonucleotide polymerase chain reaction requires more time and budget but has a sensitivity of 10⁻⁴–10⁻⁵. Both techniques have proven their value in minimal residual disease monitoring in childhood acute lymphoblastic leukaemia.

(BELG J HEMATOL 2014;5(3):81–8)

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P1.07 Jacobsen syndrome as a rare cause of neonatal thrombocytopenia

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P2.09 Impact of minimal residual disease monitoring on therapy in Belgian childhood acute lymphoblastic leukaemia

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