Blood Journal
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International consensus report on the investigation and management of primary immune thrombocytopenia

  1. Drew Provan1,
  2. Roberto Stasi2,
  3. Adrian C. Newland1,
  4. Victor S. Blanchette3,
  5. Paula Bolton-Maggs4,
  6. James B. Bussel5,
  7. Beng H. Chong6,
  8. Douglas B. Cines7,
  9. Terry B. Gernsheimer8,
  10. Bertrand Godeau9,
  11. John Grainger10,
  12. Ian Greer11,
  13. Beverley J. Hunt12,
  14. Paul A. Imbach13,
  15. Gordon Lyons14,
  16. Robert McMillan15,
  17. Francesco Rodeghiero16,
  18. Miguel A. Sanz17,
  19. Michael Tarantino18,
  20. Shirley Watson19,
  21. Joan Young20, and
  22. David J. Kuter21
  1. 1Department of Haematology, Barts and The London School of Medicine and Dentistry, London, United Kingdom;
  2. 2Department of Haematology, St George's Healthcare, National Health Service (NHS) Trust, London, United Kingdom;
  3. 3Division of Haematology/Oncology, University of Toronto, The Hospital for Sick Children, Toronto, ON;
  4. 4Department of Clinical Haematology, Manchester Royal Infirmary, Manchester, United Kingdom;
  5. 5Department of Pediatrics, New York Hospital, New York, NY;
  6. 6St George Clinical School, University of New South Wales, Sydney, Australia;
  7. 7Department of Pathology and Laboratory, Hospital of the University of Pennsylvania, Philadelphia;
  8. 8Puget Sound Blood Center and The University of Washington, Seattle;
  9. 9Service de Médecine Interne, Assistance-Publique Hôpitaux de Paris, Paris, France;
  10. 10Royal Manchester Children's Hospital, Manchester, United Kingdom;
  11. 11Hull York Medical School, University of York, York, United Kingdom;
  12. 12Thrombosis & Haemostasis, King's College, London, and Departments of Haematology, Pathology, and Rheumatology, Guy's & St Thomas' National Health Service (NHS) Foundation Trust, London, United Kingdom;
  13. 13University Children's Hospital, Basel, Switzerland;
  14. 14Obstetric Anaesthesia, St James' University Hospital, Leeds, United Kingdom;
  15. 15The Scripps Research Institute, La Jolla, CA;
  16. 16Department of Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy;
  17. 17Department of Haematology, Hospital Universitario La Fe, Valencia, Spain;
  18. 18Comprehensive Bleeding Disorders Center, Peoria, IL;
  19. 19ITP Support Association, Bedford, United Kingdom;
  20. 20Platelet Disorder Support Association, Rockville, MD; and
  21. 21Department of Hematology, Massachusetts General Hospital and Harvard Medical School, Boston


Previously published guidelines for the diagnosis and management of primary immune thrombocytopenia (ITP) require updating largely due to the introduction of new classes of therapeutic agents, and a greater understanding of the disease pathophysiology. However, treatment-related decisions still remain principally dependent on clinical expertise or patient preference rather than high-quality clinical trial evidence. This consensus document aims to report on new data and provide consensus-based recommendations relating to diagnosis and treatment of ITP in adults, in children, and during pregnancy. The inclusion of summary tables within this document, supported by information tables in the online appendices, is intended to aid in clinical decision making.

  • Submitted June 16, 2009.
  • Accepted September 22, 2009.
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