Annals of Hematology

, Volume 89, Supplement 1, pp 61–65

Chronic immune thrombocytopenic purpura—who needs medication?

  • Paula H. B. Bolton-Maggs
  • Victoria S. L. Kok
Chronic ITP

DOI: 10.1007/s00277-010-0918-0

Cite this article as:
Bolton-Maggs, P.H.B. & Kok, V.S.L. Ann Hematol (2010) 89: 61. doi:10.1007/s00277-010-0918-0


Chronic ITP (immune thrombocytopenic purpura; now defined as duration of more than 12 months) is not always associated with significant bleeding problems so that most children and adults can be managed expectantly with no medication unless surgery, accidents or other pathology mandate it. A cut-off platelet count of 30 × 109/l divides a group with no increased mortality from those whose risk is greater and in whom medication is usually appropriate. There is increasing recognition of long-term morbidity and mortality associated with immune suppression induced by medication and more recently new concerns have arisen about the long-term vascular complications of splenectomy. A more conservative approach to medication is warranted in many patients with chronic ITP.


Chronic ITPImmune thrombocytopeniaImmune modulationSplenectomy

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Paula H. B. Bolton-Maggs
    • 1
  • Victoria S. L. Kok
    • 1
  1. 1.Department of Clinical HaematologyCentral Manchester and Manchester Children’s University NHS Foundation Trust, Manchester Royal InfirmaryManchesterUK