A proposal for new definition (s) and management approach to paediatric refractory ITP: Reflections from the Intercontinental ITP Study Group
- PMID: 37641973
- DOI: 10.1111/bjh.19072
A proposal for new definition (s) and management approach to paediatric refractory ITP: Reflections from the Intercontinental ITP Study Group
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.
© 2023 British Society for Haematology and John Wiley & Sons Ltd.
References
REFERENCES
-
- Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829-3866. https://doi.org/10.1182/bloodadvances.2019000966
-
- Jayabose S, Levendoglu-Tugal O, Ozkaynkak MF, Visintainer P, Sandoval C. Long-term outcome of chronic idiopathic thrombocytopenic purpura in children. J Pediatr Hematol Oncol. 2004;26(11):724-726. https://doi.org/10.1097/00043426-200411000-00007
-
- Provan D, Arnold DM, Bussel JB, Chong BH, Cooper N, Gernsheimer T, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv. 2019;3(22):3780-3817. https://doi.org/10.1182/bloodadvances.2019000812
-
- Terrell DR, Neunert CE, Cooper N, Heitink-Pollé KM, Kruse C, Imbach P, et al. Immune thrombocytopenia (ITP): current limitations in patient management. Medicina (Kaunas). 2020;56(12):667. https://doi.org/10.3390/medicina56120667
-
- Ma J, Fu L, Chen Z, Gu H, Ma J, Wu R. High-dose dexamethasone as a replacement for traditional prednisone as the first-line treatment in children with previously untreated primary immune thrombocytopenia: a prospective, randomized single-center study. Int J Hematol. 2020;112(6):773-779. https://doi.org/10.1007/s12185-020-02977-9
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