Management of chronic childhood immune thrombocytopenic purpura: AIEOP consensus guidelines.
OBJECTIVE
The management of chronic childhood idiopathic thrombocytopenic purpura (ITP) is distinct from acute ITP. Similar to the publication on acute ITP guidelines, the AIEOP (Associazione Italiana di Ematologia e Oncologia Pediatrica) considered it appropriate to develop consensus guidelines for chronic childhood ITP to provide useful and shared information for physicians, healthcare professionals, parents and patients.


METHODS
A preliminary, evidence-based document issued by a select group of AIEOP pediatric hematologists was discussed, modified and approved during a Consensus Conference according to procedures previously validated by the AIEOP Board.


RESULTS
The guidelines give prominence to the periodical reevaluation of all the etiological hypotheses of thrombocytopenia in relation to its clinical condition. The majority of chronic ITP children do not require treatment, especially if bleeding is absent or minimal. The treatment decision depends on several factors other than the platelet count, and treatment options are suggested in relation to the therapeutic scenarios. Recommendations are given regarding support for surgery, particular hemorrhagic conditions, daily activities/sports, as well as for vaccines and drugs. Experimental treatments are also discussed.
De Mattia
Domenico
D
Dipartimento di Biomedicina dell'Eta Evolutiva, Universita di Bari, Azienda Ospedaliera Policlinico, Piazza G. Cesare 11, IT-0124 Bari, Italy. demattia@bioetaev.uniba.it
Del Vecchio
Giovanni Carlo
GC
Russo
Giovanna
G
De Santis
Attilio
A
Ramenghi
Ugo
U
Notarangelo
Lucia
L
Jankovic
Momcilo
M
Molinari
Angelo Claudio
AC
Zecca
Marco
M
Nobili
Bruno
B
Giordano
Paola
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003245:Consensus Statements as Topic; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D010976:Platelet Count; D017713:Platelet Transfusion; D011239:Prednisolone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000601:surgery*; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use; D013156:Splenectomy
D016756:Immunoglobulins, Intravenous; D018029:Rho(D) Immune Globulin; D011239:Prednisolone