Article (Scientific journals)
Primary immune thrombocytopenia in adults
Janssens, A.; Lambert, C.; Bries, G. et al.
2013In Belgian Journal of Hematology, 4 (1), p. 2-11
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Keywords :
primary immune thrombocytopenia; treatment; corticosteroids; intravenous immunoglobulins; thrombopoietin receptor agonists; rituximab
Abstract :
[en] The Belgian Hematological Society (BHS) guideline panel on adult primary immune thrombocytopenia (ITP) reviewed the recent literature on diagnosis and treatment to make recommendations on the best strategies for frontline and subsequent-line treatment. No treatment is necessary for patients with platelet counts higher than 30000/ l in the absence of bleeding symptoms. Patients newly diagnosed or relapsing after a long-term treatment-free period can be managed with corticosteroids with or without intravenous immunoglobulins. A second line therapy is indicated for those patients who are intolerant or unresponsive to or relapse after initial corticosteroid treatment and have a risk of bleeding. The guideline panel recommends splenectomy as it is the treatment with the highest curative potential and an acceptable safety pro le. If possible, splenectomy should be delayed to at least twelve months after diagnosis as spontaneous remission can occur in this time period. Thrombopoietin receptor (TPO-R) agonists are recommended for patients who are refractory to or relapse after splenectomy or who have a contra-indication to splenectomy irrespective of the duration of ITP. The guideline panel agrees that rituximab, azathioprine, cyclophosphamide, cyclosporine A, danazol, dapsone, mycophenolate mofetil and vincristine/vinblastine are potential treatment options, especially for patients refractory to TPO-R agonists.
Disciplines :
Hematology
Author, co-author :
Janssens, A.
Lambert, C.
Bries, G.
Bosly, A.
Selleslag, D.
Beguin, Yves  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Language :
English
Title :
Primary immune thrombocytopenia in adults
Publication date :
2013
Journal title :
Belgian Journal of Hematology
ISSN :
2033-3749
Publisher :
Ariez Medical Publishing, Amsterdam, Netherlands
Volume :
4
Issue :
1
Pages :
2-11
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 11 July 2013

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