What are the ASH recommendations for splenectomy to treat immune thrombocytopenic purpura (ITP) in children?

Updated: Jun 28, 2019
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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ASH recommends splenectomy for children and adolescents with chronic or persistent ITP who have significant or persistent bleeding and who do not respond to or cannot tolerate other therapies (eg, corticosteroids, IVIg, anti-D), and/or who need improved quality of life.

Given the relatively high rate of spontaneous remission in pediatric ITP, ASH suggests delaying splenectomy or other interventions with potentially serious complications for at least 12 months, unless the patient has severe and unresponsive disease or quality of life concerns that mandate more definitive therapy.

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