The usefulness of indium‐111 platelet scintigraphy beyond predicting efficacy of splenectomy

There are no clear indicators to predict the outcome of patients with immune thrombocytopenia or the response to drugs. The work of Durand et al. shows that Indium‐111 platelet scintigraphy is useful in identifying those patients who will benefit from splenectomy and lays the groundwork for studies demonstrating the increased corticosteroid dependency and rituximab refractoriness of the hepatic platelet sequestration group. Commentary on: Durand et al. Course of immune thrombocytopenia according to the site of platelet destruction identified by indium‐111 platelet scintigraphy. Br J Haematol 2025; 206:279‐289. Indium‐111 platelet scintigraphy showed that the highest percentage of patients with ITP had pure splenic sequestration of platelets. Patients with isolated hepatic sequestration were older, had more cardiovascular events and organ‐specific autoimmune diseases, were more dependent on steroids and had a lower response rate to rituximab, suggesting an increased refractoriness to immunomodulatory therapy.