When is bone marrow exam indicated in adults with suspected immune thrombocytopenia (ITP)?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
  • Print

Recommendations for adult patients are as follows:

  • In adults who are thrombocytopenic and older than 60 years, examine the bone marrow to exclude myelodysplastic syndrome or leukemia.

  • In adults whose treatment includes corticosteroids, baseline pretreatment bone marrow aspiration may be useful for future reference. Many adults have treatment-resistant chronic ITP evident after 3-6 months of treatment, and an alternative diagnosis may be pursued vigorously at that time. Marrow aspirate obtained before any steroid-induced changes may have occurred can be useful.

  • Perform bone marrow aspiration and biopsy to evaluate for possible hypoplasia or fibrosis before splenectomy is performed.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!