Is bone marrow aspiration needed in acute childhood idiopathic thrombocytopenic purpura to rule out leukemia?
OBJECTIVE: To assess the prevalence of leukemia in a series of bone marrow aspiration (BMA) samples collected to confirm provisional diagnoses of acute idiopathic thrombocytopenic purpura (ITP) in children. DESIGN: A retrospective cohort. SETTING: All BMA reports at The Hospital for Sick Children, Toronto, Ontario (a tertiary care pediatric hospital), from January 1, 1984, to May 31, 1996, were reviewed. PATIENTS: Included were BMAs performed to confirm provisional diagnoses of ITP in children (6 months to 18 years of age) with “typical” contemporaneous hematologic features of ITP (platelet count, < or =50 x 10(9)/L; hemoglobin level, > or =100 g/L [6-12 months of age] or > or =110 g/L [> 1 year of age]; white blood cell count, > or =5 x 10(9)/L [6 months to 6 years of age] or > or =4 x 10(9)/L [> 6 years of age]; and neutrophil count, > or =1.5 x 10(9)/L [6 months to 6 years of age] or > or =2 x 10(9)/L [> 6 years of age]). Children with chronic ITP, thrombocytopenia-related chronic c
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