Initial management of immune thrombocytopaenia in adults based on risk stratification

Jaydev Manikkam Umakanthan; Prajwal Dhakal; Krishna Gundabolu; Avyakta Kallam; Daniel R Almquist; Vijaya Raj Bhatt

doi:10.1136/postgradmedj-2019-136636

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Initial management of immune thrombocytopaenia in adults based on risk stratification

Journal article

Peer reviewed

Initial management of immune thrombocytopaenia in adults based on risk stratification

Jaydev Manikkam Umakanthan, Prajwal Dhakal, Krishna Gundabolu, Avyakta Kallam, Daniel R Almquist and Vijaya Raj Bhatt

Postgraduate medical journal, Vol.95(1128), pp.558-562

10/2019

DOI: 10.1136/postgradmedj-2019-136636

PMCID: PMC7295015

PMID: 31320499

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Abstract

Patients with immune thrombocytopaenia (ITP) have a wide spectrum of disease severity and bleeding risk even at similar platelet counts. Hence, additional clinical and laboratory factors may be considered in the evaluation of bleeding risk in ITP. Risk stratification based on predicted bleeding risk may help to identify high-risk patients and guide the initial management of ITP in adults requiring treatment. Recent evidence supports the use of high-dose dexamethasone therapy over prednisone in the initial management of ITP because of improved initial response rates, shorter median time to response and better safety profile. A risk-stratified approach to management of ITP is hoped to reduce bleeding complications in high-risk patients; however, the outcomes of such management approach need to be studied prospectively. Additionally, whether therapy intensification or combination of dual therapy such as intravenous immunoglobulin or rituximab in combination with dexamethasone can reduce bleeding complications in high-risk ITP should be studied in the future.

Details

Title: Subtitle: Initial management of immune thrombocytopaenia in adults based on risk stratification
Creators: Jaydev Manikkam Umakanthan - University of Nebraska Medical Center
Prajwal Dhakal - University of Nebraska Medical Center
Krishna Gundabolu - University of Nebraska Medical Center
Avyakta Kallam - University of Nebraska Medical Center
Daniel R Almquist - University of Nebraska Medical Center
Vijaya Raj Bhatt - University of Nebraska Medical Center
Resource Type: Journal article
Publication Details: Postgraduate medical journal, Vol.95(1128), pp.558-562
DOI: 10.1136/postgradmedj-2019-136636
PMID: 31320499
PMCID: PMC7295015
NLM abbreviation: Postgrad Med J
ISSN: 0032-5473
eISSN: 1469-0756
Language: English
Date published: 10/2019
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984359804602771

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