Better treatment to children with ITP: How a computanional model helps

David Schmidt developed a calculation model that helps deciding whether or not to start treatment with IVIg plasma medication.

"Children who have the blood disease ITP, Immune Thrombocytopenia, suffer from hemorrhaging, due to a shortage in blood platelets. ITP is an autoimmune disease. There is no test establishing the disease exists. The diagnosis is arrived at by excluding other diseases, such a leukaemia or infections. The bleedings may vary from skin purpura to, in the worst case, cerebral hemorrhaging.

ITP causes a lot of anxiety. It often goes away on its own, but ten percent of the children suffer from the disease for over a year. Children suffering from severe hemorrhaging are treated with a very high dose of IVIg, a plasma medicine that consists of a mixture of donor antibodies otained from a great many donations.

Rare disease

Children suffering from less severe hemorrhaging, too, are sometimes treated using IVIg. But not all these children benefit from the treatment. This has become apparent from a previous study, the TIKI study, organised by Dr Bruin and Dr Heitink of the department of Pediatric Hematology of the Utrecht UMC. Two hundred children in 48 Dutch hospitals participated in the study. This involved a great deal of organisation, as the disease is very rare.

I use the blood samples and clinical data from that study to help doctors decide which children with less severe hemorrhaging may benefit from being treated with IVIg, and which do not. This will help prevent children from running unnecessary risks of complications, while a medicine that requires donors to provide blood will be used more sparingly.

Computational model

We have computers make an unbiased consideration of multiple factors, including genetics, autoantibodies, immune cells and all sorts of lab results, such as Hb and inflammation values. Using all these data, we developed a computanional model that predicts whether a child suffering from non-severe haemorrhaging may benefit from being treated with IVIg. This model works well, but its predictions are not perfect yet. By also considering other factors, I aim to improve the quality of the prediction." 

David Schmidt is a physician-researcher who is conducting his PhD research under Professor Masja de Haas, Centre for Clinical Transfusion Research, Sanquin Research and Leiden University Medical Centre (LUMC), and Dr Gestur Vidarsson of the Experimental Immunohematology department of the Research division.