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Clinical guideline update on "Immune thrombocytopenia: an evidence based practice guideline developed by the American Society of Hematology"

Cindy Neunert, Wendy Lim, Mark Crowther, Alan Cohen, Lawrence Solberg Jr. and Mark Crowther

Abstract

Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation and presentation of the available evidence. We have endeavored to identify, abstract and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality – interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP and studies which will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first line intervention.

  • Submitted August 20, 2010.
  • Accepted January 18, 2011.