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Pediatric Refractory Immune Thrombocytopenia: a Systematic Review
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  • Layan Ibrahim,
  • Selina Dong,
  • Katie O'Hearn,
  • Amanda Grimes,
  • Stephanie FritchLilla,
  • Vicky Breakey,
  • Rachael Grace,
  • Jeffrey Lebensburger,
  • Robert Klaassen,
  • Michele Lambert
Layan Ibrahim
Vanderbilt University School of Medicine

Corresponding Author:[email protected]

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Selina Dong
University of Ottawa Faculty of Medicine
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Katie O'Hearn
Children's Hospital of Eastern Ontario Research Institute
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Amanda Grimes
Baylor College of Medicine Department of Pediatrics
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Stephanie FritchLilla
Children's Minnesota
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Vicky Breakey
McMaster University
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Rachael Grace
Dana-Farber Cancer Institute
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Jeffrey Lebensburger
The University of Alabama at Birmingham
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Robert Klaassen
Children's Hospital of Eastern Ontario Research Institute
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Michele Lambert
University of Pennsylvania Perelman School of Medicine
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Pediatric immune thrombocytopenia (ITP) is an acquired disorder associated with autoimmune destruction and impairment of platelet production in children. Some children exhibit poor or transient response to ITP-directed treatments and are referred to as having refractory ITP (rITP). There is currently no consensus on the definition of rITP, nor evidence-based treatment guidelines for patients with rITP. After a survey of pediatric ITP experts demonstrated lack of consensus on pediatric rITP, we pursued a systematic review to examine the reported clinical phenotypes and treatment outcomes in pediatric rITP. The search identified 253 relevant manuscripts; following review, 11 studies proposed a definition for pediatric rITP with no consensus amongst them. Most definitions included sub-optimal response to medical management, while some outlined specific platelet thresholds to define this sub-optimal response. Common attributes identified in this study should be used to propose a comprehensive definition, which will facilitate outcome comparisons of future rITP studies.
13 Sep 2022Submission Checks Completed
13 Sep 2022Assigned to Editor
13 Sep 2022Submitted to Pediatric Blood & Cancer
18 Sep 2022Reviewer(s) Assigned
08 Oct 2022Review(s) Completed, Editorial Evaluation Pending
09 Oct 2022Editorial Decision: Revise Minor
16 Nov 20221st Revision Received
16 Nov 2022Submission Checks Completed
16 Nov 2022Assigned to Editor
30 Nov 2022Review(s) Completed, Editorial Evaluation Pending
01 Dec 2022Reviewer(s) Assigned
02 Dec 2022Editorial Decision: Accept
Mar 2023Published in Pediatric Blood & Cancer volume 70 issue 3. 10.1002/pbc.30173