Management of newly diagnosed immune thrombocytopenia: can we change outcomes?

Abstract

Immune thrombocytopenia resulting from antibody-mediated platelet destruction combined with impaired platelet production is a common cause of thrombocytopenia. The decision to treat newly diagnosed patients is based on several factors including ceasing hemorrhagic manifestations, increasing the platelet count, prevention of bleeding, and inducing remission.Current standard first-line therapy is a course of corticosteroids. Although this treatment paradigm increases the platelet count in the majority of patients, a high percentage relapse after discontinuation of corticosteroid therapy. For this reason, intensification of first-line therapy that results in superior long-term remission rates would be desirable. This manuscript focuses primarily on adults with idiopathic thrombocytopenic purpura (ITP), highlighting pediatric data and practice when applicable. The primary aim is to outline upfront strategies for treatment-naive patients with ITP to enhance remission rates, taking into account assessment of the risks and benefits of these approaches.

Preventing infectious complications when treating non‐malignant immune‐mediated hematologic disorders

“…Rituximab is a chimeric monoclonal antibody targeting the B‐cell antigen CD20, approved for various malignant hematologic and rheumatologic disorders. It has shown efficacy in autoimmune hemolytic anemia, acquired coagulation factor deficiencies, thrombotic thrombocytopenic purpura, immune thrombocytopenic purpura (ITP), and has been used in other disorders such as antiphospholipid syndrome, and aplastic anemia, but its use in these non‐malignant immune‐mediated hematologic disorders is off‐label.…”

Thrombocytopenia – a challenge for Pediatric Emergency Departments

“…Previous long term studies showed that about 14% of children initially diagnosed with ITP were eventually diagnosed with other disorders like familial thrombocytopenia, systemic lupus erythematosus, Wiskott Aldrich syndrome etc. (3) or associated diseases (4,5).…”

Trombocitopenia – O Provocare Pentru Departamentele De Urgenţă Pediatrice

“…Studii anterioare ce au urmărit pacienţii pe termen lung au arătat că aproximativ 14% dintre copiii la care iniţial trombocitopenia a fost interpretată în cadrul PTI au fost în final diagnosticaţi cu trombocitopenie familială, lupus eritematos sistemic, sindrom Wiskott Aldrich etc. (3) sau asociau şi alte afecţiuni (4,5).…”