What are the American Society of Hematology (ASH) treatment guidelines for immune thrombocytopenia (ITP) in pediatric patients?

Updated: Dec 14, 2019
  • Author: Michael A Silverman, MD, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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American Society of Hematology (ASH) guidelines recommend that in children who have no bleeding, or only mild bleeding (ie, skin manifestations only, such as bruising and petechiae), regardless of the platelet count, management should be with observation alone. For pediatric patients requiring treatment, ASH suggests a short course of corticosteroids for first-line treatment rather than IVIG or anti-D immunoglobulin. [7]

For children or adolescents with ITP who have significant ongoing bleeding despite treatment with IVIG, RhIG, or conventional doses of corticosteroids, the ASH suggests a thrombopoietin receptor agonist (TPO-RA) rather than rituximab or splenectomy as second-line treatment. Rituximab may also be considered as an alternative to splenectomy. [7]

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