First-line therapies for immune thrombocytopenic purpura: re-evaluating the need to treat

European Journal of Haematology. Supplementum
Francesco Rodeghiero

Abstract

Immune thrombocytopenic purpura (ITP) can be challenging to both diagnose and treat: despite the ability to detect anti-platelet antibodies, the diagnosis of ITP remains one of exclusion. Management of ITP is similarly difficult as many therapies pose potential risks that may be worse than the disease. It has been generally agreed that bleeding - not platelet count - should be the rationale for treatment. Despite the absence of prospective, controlled studies, there is consensus that bleeding risks are significantly greater in patients with platelet counts <20 x 10(9)-30 x 10(9)/L, and therefore treatment is indicated for these patients; for those with platelet counts that are higher, but still <50 x 10(9)/L, treatment is also indicated if accompanied by substantial mucous membrane bleeding. The standard initial treatment for ITP is oral corticosteroids to increase platelet counts. Intravenous immunoglobulin or anti-D immunoglobulin can also increase platelet counts and are particularly useful for stimulating rapid platelet increases before planned procedures. Splenectomy, which produces a long-lasting response in a majority of patients, is still commonly used for those who do not have long-term responses to steroid therapy and...Continue Reading

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Nov 26, 2010·Cell Biochemistry and Biophysics·Hui FanYang Liu
May 30, 2013·Hematology/oncology Clinics of North America·Gaurav Kistangari, Keith R McCrae
Nov 1, 2011·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·O Erhabor, T C Adias
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Aug 8, 2021·Journal of Clinical Medicine·Anne-Tess C JolinkRick Kapur

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