Recommendations for the management of acute immune thrombocytopenia in children. A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology
Immune thrombocytopenia (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated thrombocytopenia. Its estimated yearly incidence in the pediatric population is 1.9-6.4/100,000. ITP in children is usually a self-limiting and benign disorder. The clinical management of childre...
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| creator | Russo, Giovanna Parodi, Emilia Farruggia, Piero Notarangelo, Lucia D Perrotta, Silverio Casale, Maddalena Cesaro, Simone Del Borrello, Giovanni Del Vecchio, Giovanni C Giona, Fiorina Gorio, Chiara Ladogana, Saverio Lassandro, Giuseppe Marzollo, Antonio Maslak, Karolina Miano, Maurizio Nardi, Margherita Palumbo, Giuseppe Rossi, Francesca Spinelli, Marco Tolva, Alessandra Saracco, Paola Ramenghi, Ugo Giordano, Paola |
| description | Immune thrombocytopenia (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated thrombocytopenia. Its estimated yearly incidence in the pediatric population is 1.9-6.4/100,000. ITP in children is usually a self-limiting and benign disorder. The clinical management of children with ITP often remains controversial, as robust randomized trials on the management of this disorder are lacking. Treatments vary widely in clinical practice and existing guidelines from hematology societies on clinical management offer indications based largely on expert opinion rather than strong evidence.
The Coagulative Disorder Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) developed this document to collect shared expert opinions on the management of newly diagnosed ITP, updating previous guidelines and providing recommendations to pediatricians. Each statement has been given a score expressing the strength of evidence, appropriateness and agreement among participants.
Clear-cut definitions of the clinical phases of the disease and clinical response are stated. Recommendations are given regarding the classification of bleeding symptoms, evaluation of bleeding risk, diagnosis, and prognostic factors. Specific recommendations for treatment include indications for first-line (intravenous immunoglobulins, steroids) and second-line (combined therapy, thrombopoietin receptor agonists, immunosuppressive drugs, rituximab) therapeutic agents, as well as hemorrhagic emergency and supportive treatment, including emergency splenectomy. The optimal follow-up schedule, the relation between ITP and vaccines and health-related quality-of-life issues are also discussed.
The panel achieved broad consensus on issues related to how to treat children with newly diagnosed ITP, providing a comprehensive review of all relevant clinical aspects. |
| doi_str_mv | 10.2450/BloodTransfus.501 |
| format | Article |
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The Coagulative Disorder Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) developed this document to collect shared expert opinions on the management of newly diagnosed ITP, updating previous guidelines and providing recommendations to pediatricians. Each statement has been given a score expressing the strength of evidence, appropriateness and agreement among participants.
Clear-cut definitions of the clinical phases of the disease and clinical response are stated. Recommendations are given regarding the classification of bleeding symptoms, evaluation of bleeding risk, diagnosis, and prognostic factors. Specific recommendations for treatment include indications for first-line (intravenous immunoglobulins, steroids) and second-line (combined therapy, thrombopoietin receptor agonists, immunosuppressive drugs, rituximab) therapeutic agents, as well as hemorrhagic emergency and supportive treatment, including emergency splenectomy. The optimal follow-up schedule, the relation between ITP and vaccines and health-related quality-of-life issues are also discussed.
The panel achieved broad consensus on issues related to how to treat children with newly diagnosed ITP, providing a comprehensive review of all relevant clinical aspects.</description><identifier>ISSN: 1723-2007</identifier><identifier>EISSN: 2385-2070</identifier><identifier>DOI: 10.2450/BloodTransfus.501</identifier><identifier>PMID: 37677093</identifier><language>eng</language><publisher>Italy: Edizioni SIMTI - SIMTI Servizi Srl</publisher><subject>Acute Disease ; Child ; Child, Preschool ; Female ; Hematology ; Hemorrhage - etiology ; Hemorrhage - therapy ; Hemostasis and Thrombosis ; Humans ; Immunoglobulins, Intravenous - therapeutic use ; Italy ; Male ; Purpura, Thrombocytopenic, Idiopathic - diagnosis ; Purpura, Thrombocytopenic, Idiopathic - epidemiology ; Purpura, Thrombocytopenic, Idiopathic - therapy</subject><ispartof>Blood transfusion = Trasfusione del sangue, 2024-05, Vol.22 (3), p.253-265</ispartof><rights>SIMTI Servizi Srl 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073630/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073630/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37677093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Russo, Giovanna</creatorcontrib><creatorcontrib>Parodi, Emilia</creatorcontrib><creatorcontrib>Farruggia, Piero</creatorcontrib><creatorcontrib>Notarangelo, Lucia D</creatorcontrib><creatorcontrib>Perrotta, Silverio</creatorcontrib><creatorcontrib>Casale, Maddalena</creatorcontrib><creatorcontrib>Cesaro, Simone</creatorcontrib><creatorcontrib>Del Borrello, Giovanni</creatorcontrib><creatorcontrib>Del Vecchio, Giovanni C</creatorcontrib><creatorcontrib>Giona, Fiorina</creatorcontrib><creatorcontrib>Gorio, Chiara</creatorcontrib><creatorcontrib>Ladogana, Saverio</creatorcontrib><creatorcontrib>Lassandro, Giuseppe</creatorcontrib><creatorcontrib>Marzollo, Antonio</creatorcontrib><creatorcontrib>Maslak, Karolina</creatorcontrib><creatorcontrib>Miano, Maurizio</creatorcontrib><creatorcontrib>Nardi, Margherita</creatorcontrib><creatorcontrib>Palumbo, Giuseppe</creatorcontrib><creatorcontrib>Rossi, Francesca</creatorcontrib><creatorcontrib>Spinelli, Marco</creatorcontrib><creatorcontrib>Tolva, Alessandra</creatorcontrib><creatorcontrib>Saracco, Paola</creatorcontrib><creatorcontrib>Ramenghi, Ugo</creatorcontrib><creatorcontrib>Giordano, Paola</creatorcontrib><title>Recommendations for the management of acute immune thrombocytopenia in children. A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology</title><title>Blood transfusion = Trasfusione del sangue</title><addtitle>Blood Transfus</addtitle><description>Immune thrombocytopenia (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated thrombocytopenia. Its estimated yearly incidence in the pediatric population is 1.9-6.4/100,000. ITP in children is usually a self-limiting and benign disorder. The clinical management of children with ITP often remains controversial, as robust randomized trials on the management of this disorder are lacking. Treatments vary widely in clinical practice and existing guidelines from hematology societies on clinical management offer indications based largely on expert opinion rather than strong evidence.
The Coagulative Disorder Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) developed this document to collect shared expert opinions on the management of newly diagnosed ITP, updating previous guidelines and providing recommendations to pediatricians. Each statement has been given a score expressing the strength of evidence, appropriateness and agreement among participants.
Clear-cut definitions of the clinical phases of the disease and clinical response are stated. Recommendations are given regarding the classification of bleeding symptoms, evaluation of bleeding risk, diagnosis, and prognostic factors. Specific recommendations for treatment include indications for first-line (intravenous immunoglobulins, steroids) and second-line (combined therapy, thrombopoietin receptor agonists, immunosuppressive drugs, rituximab) therapeutic agents, as well as hemorrhagic emergency and supportive treatment, including emergency splenectomy. The optimal follow-up schedule, the relation between ITP and vaccines and health-related quality-of-life issues are also discussed.
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A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology</atitle><jtitle>Blood transfusion = Trasfusione del sangue</jtitle><addtitle>Blood Transfus</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>22</volume><issue>3</issue><spage>253</spage><epage>265</epage><pages>253-265</pages><issn>1723-2007</issn><eissn>2385-2070</eissn><abstract>Immune thrombocytopenia (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated thrombocytopenia. Its estimated yearly incidence in the pediatric population is 1.9-6.4/100,000. ITP in children is usually a self-limiting and benign disorder. The clinical management of children with ITP often remains controversial, as robust randomized trials on the management of this disorder are lacking. Treatments vary widely in clinical practice and existing guidelines from hematology societies on clinical management offer indications based largely on expert opinion rather than strong evidence.
The Coagulative Disorder Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) developed this document to collect shared expert opinions on the management of newly diagnosed ITP, updating previous guidelines and providing recommendations to pediatricians. Each statement has been given a score expressing the strength of evidence, appropriateness and agreement among participants.
Clear-cut definitions of the clinical phases of the disease and clinical response are stated. Recommendations are given regarding the classification of bleeding symptoms, evaluation of bleeding risk, diagnosis, and prognostic factors. Specific recommendations for treatment include indications for first-line (intravenous immunoglobulins, steroids) and second-line (combined therapy, thrombopoietin receptor agonists, immunosuppressive drugs, rituximab) therapeutic agents, as well as hemorrhagic emergency and supportive treatment, including emergency splenectomy. The optimal follow-up schedule, the relation between ITP and vaccines and health-related quality-of-life issues are also discussed.
The panel achieved broad consensus on issues related to how to treat children with newly diagnosed ITP, providing a comprehensive review of all relevant clinical aspects.</abstract><cop>Italy</cop><pub>Edizioni SIMTI - SIMTI Servizi Srl</pub><pmid>37677093</pmid><doi>10.2450/BloodTransfus.501</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Blood transfusion = Trasfusione del sangue, 2024-05, Vol.22 (3), p.253-265 |
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| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Acute Disease Child Child, Preschool Female Hematology Hemorrhage - etiology Hemorrhage - therapy Hemostasis and Thrombosis Humans Immunoglobulins, Intravenous - therapeutic use Italy Male Purpura, Thrombocytopenic, Idiopathic - diagnosis Purpura, Thrombocytopenic, Idiopathic - epidemiology Purpura, Thrombocytopenic, Idiopathic - therapy |
| title | Recommendations for the management of acute immune thrombocytopenia in children. A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology |
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