• The life expectancy of people with chronic immune thrombocytopenia (ITP) is about the same as that of people without the condition.
• Treatments can help decrease the risk of life-threatening situations like infections and severe bleeding due to ITP.
• In people with ITP, complications and comorbidities (unrelated health conditions) are usually the cause of death versus ITP itself.

If you were recently diagnosed with chronic immune thrombocytopenia — also known as immune thrombocytopenic purpura — you might be wondering how it’ll affect your prognosis (outlook).

Generally speaking, most people with chronic ITP respond well to treatment and can live around as long as people without ITP. Some factors, like the cause of your ITP and the treatments you receive, can affect your outlook. New advances in medications can help relieve your ITP symptoms and increase your platelet counts.

In this article, we’ll discuss what chronic ITP is and how it can affect your life expectancy. We’ll also cover other conditions and diseases that are common in people with chronic ITP and how they can affect your outlook.

Life Expectancy and Chronic ITP

Life expectancy refers to how long you’re expected to live with a certain disease. For people with ITP, this amount of time can vary. There are two forms of ITP — acute and chronic. Acute ITP typically goes away within six months, either on its own or with treatment.

On the other hand, chronic ITP is a long-term condition that may last several years or for your lifetime. Both children and adults can develop chronic ITP. Children under 10 are more likely to go into remission (have their symptoms resolved) as compared to older children. The biggest risk factor affecting life expectancy in children with chronic ITP is an increased bleeding risk.

Adults can live for several years to decades with chronic ITP. Studies show that most people with mild and moderate ITP have similar life expectancy to the general population (those without ITP or other health conditions). Overall, though, the average life span among people with ITP is shorter than that of the general population due to increased risk factors including high infection rates, hemorrhaging, heart disease, and blood cancer.

For people with refractory ITP that’s resistant to treatment, the risk of death is higher. This increased risk of death is due to infections, hemorrhages and severe bleeding, and other ITP-related complications.

Primary vs. Secondary ITP

The cause of your ITP can also affect your prognosis. Primary ITP refers to ITP that isn’t related to an underlying cause. Secondary ITP is caused by another condition or disease — like taking certain medications or having another autoimmune disease. A 2001 study found that people with secondary ITP had a higher risk of death as compared to those with primary ITP.

One study from Denmark of 1,762 people with chronic ITP found that the median survival rate for those with primary ITP was 5.1 years lower than that of the general population. The median survival rate for those with secondary ITP was 11.1 years lower.

Chronic ITP Treatments and Life Expectancy

Chronic ITP is an autoimmune disease that occurs when your immune system attacks your platelets. These blood cells are responsible for helping your blood clot. When you have a low platelet count, you’re at a higher risk of severe bleeding, which can be life-threatening if left untreated.

The right treatment plan can help prevent platelet destruction and relieve your chronic ITP symptoms. The most common first-line (first-choice) treatment options include corticosteroids like prednisone or intravenous immunoglobulin (IVIG). Researchers have found that more than 80 percent of people newly diagnosed with ITP see an increase in platelet levels when being treated with IVIG. Those taking corticosteroids have an initial response rate of between 60 percent and 80 percent.

Second-line and third-line treatment options for chronic ITP include:

• Rituximab (Rituxan) — Medication that blocks immune cells from making antibodies (immune system proteins) that destroy platelets
• Thrombopoietin receptor agonists — Medications that trigger platelet production in the bone marrow (the soft tissue inside your bones), including eltrombopag (Promacta) and romiplostim (Nplate)
• Splenectomy — Surgery to remove your spleen, which plays a role in platelet destruction
• Immunosuppressants — Medications, including azathioprine, that block the function of your immune system

There currently aren’t any studies that show if certain chronic ITP treatments can help increase your life expectancy. Health experts do know that they can help lower your risk of severe bleeding — this is one of the main causes of death in people with chronic ITP. By managing your symptoms, you may be able to improve your life expectancy and quality of life.

Complications From Chronic ITP Treatments

While the different treatment options for chronic ITP help raise platelet counts and improve symptoms, they can come with some unwanted complications. In some cases, these complications can affect your life expectancy.

For example, although immunosuppressants help treat chronic ITP, they make it harder for your body to fight infections. People with chronic ITP are more likely to experience life-threatening bacterial or viral infections.

If you’re concerned about side effects or complications from your treatments, talk to your doctor. They can help you understand your risks and change your treatment plan if needed.

Common Comorbidities of Chronic ITP

Chronic ITP isn’t usually a cause of death. Instead, other conditions or complications are more likely. A comorbid condition or comorbidity occurs alongside another condition. For example, if you have diabetes and chronic ITP at the same time, they’re considered comorbidities.

One study from Denmark found that people with ITP were at a higher risk of dying from the following conditions compared to people in the general population:

• Infections
• Blood cancers like leukemia or lymphoma
• Hemorrhages or severe bleeding
• Cardiovascular (heart and lung) conditions

Other comorbidities that may affect your life expectancy when living with chronic ITP include diabetes and high blood pressure. Fortunately, these conditions can be treated with medications and lifestyle changes. You can work with your doctor to make a treatment plan to address them before they have an impact on your health.

How To Manage the Risks of Chronic ITP

Chronic ITP is a long-term condition that needs to be properly managed. It’s important to work closely with your doctor or hematologist to monitor your symptoms and change your treatment plan as needed.

Be sure to go to your regular medical checkups for bloodwork and your platelet count. These results let your health care provider know whether your current treatments are working or whether they need to be adjusted. Take your medication as prescribed and follow your doctor’s instructions.

If you start to notice any new symptoms of ITP coming back, like new bleeding or bruising, schedule an appointment with your doctor. This is especially true if you’ve had your spleen removed and have recently been sick. Your body has to work harder to fight infections without a spleen, which can become dangerous if left untreated. It’s also a good idea to talk to your doctor about what vaccinations you may need.

Chronic ITP increases your risk of bleeding, so talk to your doctor about what over-the-counter medications are best for you to take. Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium (Aleve) and ibuprofen (Motrin, Advil) thin your blood. They may be hiding in cold medicines, cough syrups, and other medications at the pharmacy. Read the drug labels closely when shopping.

Mayo Clinic also recommends avoiding contact sports and other activities during which you may be hit or injured. This is because these activities increase the risk of a brain bleed, which can become dangerous very quickly for people with ITP.

Talk With Others Who Understand

On myITPcenter, the site for people with immune thrombocytopenia and their loved ones, people come together to gain a new understanding of ITP and share their stories with others who understand life with ITP.

Do you have more questions about how chronic ITP affects life expectancy? Share your questions in the comments below.