Clinical characteristics in immune thrombocytopenia patients after COVID-19 vaccination

Figures & data

Figure 1. The effect of COVID-19 vaccination on patients with historically diagnosed ITP. a: Analysis of the degree of platelet decline in ITP patients after vaccination, compared with the platelet base level before vaccination. b: Proportion of ITP patients with platelet deterioration after the first, second and third dose. c and d: Response to therapy in ITP patients with PC decline after vaccination.

Table 1. The effect of COVID-19 vaccination on patients with historically diagnosed ITP.

Pts	Gender	Age (years)	The ITP course (months, till to 2021/10/31)	PC before the first dose vaccine (×10^9/L)	PC after vaccination (×10^9/L) (1,2,3 dose)	Organ bleeding	Bleeding score	Therapy after vaccination	Previous therapeutic regimes	PC after treatment at 3M (×10^9/L)	Efficacy evaluation after 3M
1	Male	61	36	70	65 (2)	Skin petechia	1	TCM	Chinese patent drug (SXXB, xuemeian capsule)	65	SD
2	Female	36	60	94	86 (1)	None	0	None	Chinese patent drug (SXXB)	117	CR
3	Female	55	72	90	77 (1)	None	0	leucogen	/	77	SD
4	Male	87	120	26	22 (2)	None	0	TCM	Chinese patent drug (SXXB), Rapamycin	11	NR
5	Female	50	9	97	74 (2)	None	0	TCM	Chinese patent drug (SXXB)	99	PR
6	Female	44	12	50	38 (2)	None	0	Rapamycin	rhIL-11, rhTPO, Chinese patent drug (SXXB), dexamethasone	83	PR
7	Female	58	21	80	60 (1)	None	0	None	/	104	CR
8	Female	26	36	57	40 (1)	None	0	TCM	Chinese patent drug (SXXB)	92	PR
9	Female	64	5	55	34(1)	None	0	TCM	Prednisone, Rapamycin, MMF	50	SD
10	Female	83	120	69	41(1)	Skin petechia	3	None	/	91	PR
11	Female	51	24	70	41 (2)	Fundus, urinary tract	3	TCM	Rapamycin	58	SD
12	Female	67	15	111	55 (1)	None	0	Rapamycin	Chinese patent drug (SXXB), dexamethasone	82	PR
13	Male	31	12	89	39 (2)	None	0	None	/	105	CR
14	Male	41	156	55	24 (1)	None	0	cyclosporine A	Prednisone, Rapamycin, Hetrombopag, dexamethasone	20	NR
15	Female	38	12	100	41 (1)	None	0	None	Rapamycin	75	PR
16	Female	73	9	20	7 (2)	Skin petechia	2	Eltrombopag +Rapamycin	rhTPO	23	NR
17	Male	14	40	206	68 (2)	None	0	Eltrombopag	Prednisone, Cyclosporine A,	153	CR
18	Female	69	36	100	30 (1)	None	0	TCM	Chinese patent drug (SXXB)	84	PR
19	Female	20	12	256	64 (1)	None	0	Rapamycin	Rapamycin	193	CR
20	Female	59	18	105	25 (1)	None	0	None	/	67	PR
21	Female	29	9	67	13 (1)	None	0	Prednisone	Prednisone	57	PR
22	Female	47	72	40	6 (2)	Skin petechia	1	Eltrombopag + Rapamycin	Dexamethasone, rhTPO	71	PR
23	Female	46	3	100	9 (1)	None	0	Hetrombopag	Prednisone, rhTPO, Rapamycin	68	PR
24	Female	67	12	70	6 (1)	None	0	Rapamycin	dexamethasone	105	CR
25	Female	58	115	200	8 (1)	None	0	Tacrolimus	Prednisone, IVIG, Eltrombopag, Rituximab, rhTPO	38	PR
26	Female	57	276	50	0 (3)	Oral blood blister	2	Azathioprine +Prednisone	Prednisone	55	PR
27	Male	73	24	86	127 (NA)	None	0	Rapamycin	Eltrombopag	107	CR
28	Female	55	180	7	7 (NA)	None		Rapamycin	dexamethasone	108	CR

Note: Abbreviations: PC, platelet counts; TCM, traditional Chinese medicine; SXXB, shengxuexiaoban capsule; rhIL-11, recombinant human interleukin-11; rhTPO, recombinant human thrombopoietin; MMF, mycophenolate mofetil; IVIG, intravenous immunoglobulin; CR, complete response; PR, partial response; SD, stable disease; NR, no response; NA, not applicable.

Figure 2. The effect of COVID-19 vaccination on new diagnosed ITP patients claiming previous normal PC. a: After 3 months of treatment, the platelets of all patients recovered significantly to 139.4 × 10⁹/L. b: Response to therapy in ITP patients with PC decline after vaccination. ORR (CR+PR) is 100%. c: Proportion of ITP patients with platelet deterioration after the first, second and third dose.

Table 2. The effect of COVID-19 vaccination on newly diagnosed ITP patients claiming previous normal platelet counts.

Pts	Gender	Age (years)	PC before vaccination (×10^9/L)	PC after vaccination (×10^9/L) (1,2,3 dose)	Organ bleeding	Bleeding score	Abnormal indexes detected	ITP therapy	Therapeutic effect	PC after treat 3 M (×10^9/L)	Efficacy evaluation after 3 M
1	Female	34	Normal	10 (2)	Skin petechia	1	anti-SSA+，FT4↓，T4↓，TSH↑	Dexamethasone + rapamycin	After 2 weeks of treatment, PC returned to normal	266	CR
2	Male	26	Normal	58 (2)	none	0	anti-nRNP/Sm+，anti-SSA+	leucogen	PC returned to normal	101	CR
3	Female	46	334	37 (2)	hematuria	3	anti-ACA++， anti-SSA+，ANA1:320 positive	Prednisone + cyclosporine A	After 20 days of treatment, PC recovered to 125 × 10^9/L	169	CR
4	Female	40	Normal	65 (2)	none	0	anti-nRNP/Sm+, anti-AHA+	Avatrombopag	One week of treatment got normal PC, but decreased after drug discontinuation, resumed treatment and resumed CR	288	CR
5	Female	48	Normal	12 (1)	Vaginal bleeding	3	anti-PM-Scl+, anti-AnuA+, anti-AHA+++	Dexamethasone + rapamycin	Self-discontinuation after one month of treatment	86	PR
6	Female	58	Normal	50 (2)	none	0	Hypothyroidism	Untreated	Without medication, PC returned to normal on its own	113	CR
7	Male	46	Normal	20 (2)	none	0	βThalassemia mild	Dexamethasone + rapamycin	After 2 weeks of treatment, PC recovered to 61 × 10^9/L	65	PR
8	Male	64	Normal	59 (1)	none	0	HBsAg+，Rheumatoid factor+	Untreated	Without medication, PC returned to normal on its own	184	CR
9	Male	82	120	80 (1)	none	0	/	Untreated	Without medication, PC returned to normal on its own	116	CR
10	Female	41	Normal	19 (1)	Skin petechia	1	/	rhTPO	PC returned to normal after 1 month	50	PR
11	Female	57	Normal	42 (2)	none	0	anti-SSA+++, anti-SS-B+++，ANA1:320 positive	rhTPO+rapamycin	PC returned to normal after 2 weeks	83	PR
12	Female	35	Normal	1 (3)	Skin petechia	1	anti-SSA+, ANA1:100 positive	IVIG+rhTPO +methylprednisolone	PC returned to normal after 2 weeks	297	CR
13	Female	30	Normal	78 (1)	none	0	/	Untreated	Without medication, PC returned to normal on its own	83	PR
14	Female	66	Normal	2 (1)	none	0	/	Dexamethasone	Glucocorticoid therapy is effective	51	PR

Abbreviations: PC, platelet counts; TCM, traditional Chinese medicine; rhIL-11, recombinant human interleukin-11; rhTPO, recombinant human thrombopoietin; MMF, mycophenolate mofetil; IVIG, intravenous immunoglobulin; CR, complete response; PR, partial response; SD, stable disease; NR, no response; anti-SSA, anti-Sjogren’s-syndrome-related antigen a autoantibodies; FT4, free thyroxine; T4, total thyroxine; TSH, thyroid-stimulating hormone; anti-nRNP/Sm, antinuclear antibody, ribonucleoproteins antibody; ACA, Anti-centromere antibodies; ANA, antinuclear antibody; anti-AHA, Anti-Histone antibody; HBsAg, Hepatitis B virus surface antigen.