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The Treatment of Immune Thrombocytopenia

  • Kandace L. Gollomp
  • Michele P. Lambert
Chapter

Abstract

Immune thrombocytopenia (ITP) results in variable bleeding symptoms and thrombocytopenia. In the last decade, advances in our understanding of the pathophysiology of the disorder have led to the publication of new guidelines for the treatment of ITP, as well as standards for terminology. Although frontline management recommendations remain relatively unchanged, current evidence supports alternatives to splenectomy for second-line management of patients with persistently low platelet counts and bleeding. Long-term follow-up data suggest both efficacy and safety for the thrombopoietin receptor agonists (TPO-RAs). Follow-up of patients who have undergone splenectomy for ITP reveals significant potential risks that should be discussed with patients and may influence clinician and patient choice of treatment. Novel therapeutics are in development to address ongoing treatment gaps.

Keywords

Immune thrombocytopenia TPO-RA Intravenous immunoglobulin Corticosteroids Rituximab Eltrombopag Antimetabolites 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of HematologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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