Which medications are recommended for the treatment of chronic immune thrombocytopenia (ITP) in pediatric patients?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Although a number of agents (eg, dapsone) have been studied for treatment of pediatric patients with chronic ITP that is refractory to conventional agents, the American Society of Hematology found insufficient evidence to support recommendations regarding their use. American Society of Hematology guidelines suggest the following for treatment of refractory chronic ITP in children and adolescents who have non–life-threatening mucosal bleeding and/or diminished health-related quality of life [21] :

  • Thrombopoietin receptor agonist (eltrombopag or romiplostim) over rituximab or splenectomy 
  • Rituximab over splenectomy 

Children with chronic ITP who are scheduled for splenectomy should receive pneumococcal and Haemophilus influenzae vaccines before the operation. Many physicians recommend that patients receive a prophylactic antibiotic regimen after splenectomy.

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