Recommendations for the management of acute immune thrombocytopenia in children. A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology.

Autor:	Russo G; Pediatric Onco-hematology Unit, Azienda Policlinico Rodolico San Marco, Department of Clinical and Experimental Medicine, University of Catania, Italy., Parodi E; Pediatric and Neonatology Unit, Ordine Mauriziano Hospital, Turin, Italy., Farruggia P; Pediatric Hematology and Oncology Unit, ARNAS Ospedale Civico, Palermo, Italy., Notarangelo LD; Direzione Medica di Presidio, Children's Hospital, ASST-Spedali Civili, Brescia, Italy., Perrotta S; Department of Women, Children and General and Specialized Surgery, 'Luigi Vanvitelli' Università degli Studi della Campania, Naples, Italy., Casale M; Department of Women, Children and General and Specialized Surgery, 'Luigi Vanvitelli' Università degli Studi della Campania, Naples, Italy., Cesaro S; Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy., Del Borrello G; Pediatric Oncohematology, Pediatrics Department, Hospital Città Della Salute e Della Scienza, University of Turin, Turin, Italy., Del Vecchio GC; Interdisciplinary Department of Medicine, Pediatric Section, 'Aldo Moro' University of Bari, Bari, Italy., Giona F; Department of Translational and Precision Medicine, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy., Gorio C; Pediatric Onco-hematology Unit, Children's Hospital, ASST-Spedali Civili, Brescia, Italy., Ladogana S; Pediatric Onco-hematology Unit 'Casa Sollievo della Sofferenza' Hospital, IRCCS, San Giovanni Rotondo, Italy., Lassandro G; Interdisciplinary Department of Medicine, Pediatric Section, 'Aldo Moro' University of Bari, Bari, Italy., Marzollo A; Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Padua, Italy., Maslak K; Pediatric Onco-hematology Unit, Azienda Policlinico Rodolico San Marco, Department of Clinical and Experimental Medicine, University of Catania, Italy., Miano M; Hematology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Nardi M; Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, S. Chiara Hospital, Pisa, Italy., Palumbo G; Department of Pediatric Hematology and Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Department of Systems Medicine, University of Tor Vergata, Rome, Italy., Rossi F; Department of Women, Children and General and Specialized Surgery, 'Luigi Vanvitelli' Università degli Studi della Campania, Naples, Italy., Spinelli M; Pediatric Hematology Oncology Unit, Department of Pediatrics, IRCCS San Gerardo dei Tintori Foundation, Monza, Italy., Tolva A; Pediatric Hematology-Oncology, IRCCS Policlinico San Matteo, Pavia, Italy., Saracco P; Department of Public Health and Pediatric Sciences, Regina Margherita Children's Hospital, University of Turin, Turin, Italy., Ramenghi U; Department of Public Health and Pediatric Sciences, Regina Margherita Children's Hospital, University of Turin, Turin, Italy., Giordano P; Interdisciplinary Department of Medicine, Pediatric Section, 'Aldo Moro' University of Bari, Bari, Italy.
Jazyk:	angličtina
Zdroj:	Blood transfusion = Trasfusione del sangue [Blood Transfus] 2024 May; Vol. 22 (3), pp. 253-265. Date of Electronic Publication: 2024 Jan 29.
DOI:	10.2450/BloodTransfus.501
Abstrakt:	Background: Immune thrombocytopenia (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated thrombocytopenia. Its estimated yearly incidence in the pediatric population is 1.9-6.4/100,000. ITP in children is usually a self-limiting and benign disorder. The clinical management of children with ITP often remains controversial, as robust randomized trials on the management of this disorder are lacking. Treatments vary widely in clinical practice and existing guidelines from hematology societies on clinical management offer indications based largely on expert opinion rather than strong evidence. Materials and Methods: The Coagulative Disorder Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) developed this document to collect shared expert opinions on the management of newly diagnosed ITP, updating previous guidelines and providing recommendations to pediatricians. Each statement has been given a score expressing the strength of evidence, appropriateness and agreement among participants. Results: Clear-cut definitions of the clinical phases of the disease and clinical response are stated. Recommendations are given regarding the classification of bleeding symptoms, evaluation of bleeding risk, diagnosis, and prognostic factors. Specific recommendations for treatment include indications for first-line (intravenous immunoglobulins, steroids) and second-line (combined therapy, thrombopoietin receptor agonists, immunosuppressive drugs, rituximab) therapeutic agents, as well as hemorrhagic emergency and supportive treatment, including emergency splenectomy. The optimal follow-up schedule, the relation between ITP and vaccines and health-related quality-of-life issues are also discussed. Discussion: The panel achieved broad consensus on issues related to how to treat children with newly diagnosed ITP, providing a comprehensive review of all relevant clinical aspects.
Databáze:	MEDLINE
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