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Review
. 2023 Oct;203(1):17-22.
doi: 10.1111/bjh.19072. Epub 2023 Aug 29.

A proposal for new definition (s) and management approach to paediatric refractory ITP: Reflections from the Intercontinental ITP Study Group

Cindy Neunert  1 , Katja M J Heitink-Polle  2 , Michele P Lambert  3   4
Affiliations
Review

A proposal for new definition (s) and management approach to paediatric refractory ITP: Reflections from the Intercontinental ITP Study Group

Cindy Neunert et al. Br J Haematol. 2023 Oct.

Abstract

Immune thrombocytopenia (ITP) in children is a relatively mild and self-limited disorder with the majority of children demonstrating normalization of platelet count by 12 months from diagnosis. Because of this, many children with ITP can be observed without the need for treatment. When needed, treatment with either intravenous immunoglobulin (IVIG) or corticosteroids is highly effective (>80% IVIG and >95% corticosteroids). For those children who require second-line therapies, response rates of >60% are seen with both the thrombopoietin-receptor agonists and rituximab. Despite this, some children will have 'refractory' ITP (rITP) with poor or transient responses to platelet-raising therapies. Here, we review the clinical features of rITP in children, outline proposed classifications and explore potential predictors for children with rITP.

Keywords: definition; immune thrombocytopenia; management; paediatrics; refractory ITP.

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