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Medicina
Special Issues
Immune Thrombocytopenia (ITP): Diagnosis and Treatment
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Special Issue "Immune Thrombocytopenia (ITP): Diagnosis and Treatment"

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: 20 September 2023 | Viewed by 1730

Special Issue Editors

Dr. Tomas Jose Gonzalez-Lopez

E-Mail Website
Guest Editor
Hematology Department, Hospital Universitario de Burgos, 09006 Burgos, Spain
Interests: wAIHA; immune thrombocytopenia; ITP; multiple myeloma; chemotherapy; acute mye-loid leukaemia; leukaemia
Special Issues, Collections and Topics in MDPI journals
Dr. Drew Provan
E-Mail Website
Guest Editor
Barts and The London School of Medicine and Dentistry, London, UK
Interests: immune thrombocytopenia; ITP

Special Issue Information

Dear Colleagues,

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet counts (<100 × 109/L), whose diagnosis is based on first discarding other conditions that could be associated with thrombocytopenia.

In recent years, new discoveries have been made regarding ITP diagnosis and treatment. Thus, although ITP is still recognized on the basis of an exclusion diagnosis, new lab tools such as those proposed by molecular biology studies have acquired increasing importance. Furthermore, new drugs such as thrombopoietin (TPO) analogues and spleen tyrosine kinase (Syk) inhibitors have been developed and extensively used in the last years.

Given the growing interest in ITP beyond routine daily clinical practice management, the journal Medicina is launching this Special Issue.

We encourage you and your co-workers to submit articles reporting on ITP. Reviews or original articles dealing with aspects associated with diagnosis, differential diagnosis, the management of primary ITP, and therapeutic possibilities, as well as case reports of special interest, are welcome. In addition, we warmly invite you to submit articles reporting on less frequent types of ITP, e.g., ITP secondary to autoimmune or infectious diseases and lymphoproliferative disorders, drug-induced ITP, etc.

We look forward to receiving your contributions and realizing an interesting and complete Special Issue!

Dr. Tomás José González-López
Dr. Drew Provan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • immune thrombocytopenia, diagnosis, treatment
  • thrombopoietin
  • thrombopoietin analogues
  • immunosuppression
  • eltrombopag
  • romiplostim
  • rituximab
 

Published Papers (2 papers)

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Article
Sustained Remission Off-Treatment (SROT) of TPO-RAs: The Burgos Ten-Step Eltrombopag Tapering Scheme
by
Tomás José González-López
and
Drew Provan
Medicina 2023, 59(4), 659; https://doi.org/10.3390/medicina59040659 - 27 Mar 2023
Viewed by 730
Abstract
Background and Objectives: TPO-RAs (romiplostim/eltrombopag/avatrombopag) have broadly demonstrated high efficacy rates (59–88%), durable responses (up to three years) and a satisfactory safety profile in clinical trials. The effect of TPO-RAs is classically considered to be transient because platelet numbers usually dropped rapidly to [...] Read more.
Background and Objectives: TPO-RAs (romiplostim/eltrombopag/avatrombopag) have broadly demonstrated high efficacy rates (59–88%), durable responses (up to three years) and a satisfactory safety profile in clinical trials. The effect of TPO-RAs is classically considered to be transient because platelet numbers usually dropped rapidly to baseline unless therapy was maintained. However, several groups have reported the possibility of successfully discontinuing TPO-RAs in some patients without further need for concomitant treatments. This concept is usually referred as sustained remission off-treatment (SROT). Materials and Methods: Unfortunately, we still lack predictors of the response to discontinuation even after the numerous biological, clinical and in vitro studies performed to study this phenomenon. The frequency of successful discontinuation is matter of controversy, although a percentage in the range of 25–40% may probably be considered a consensus. Here, we describe all major routine clinical practice studies and reviews that report the current position on this topic and compare them with our own results in Burgos. Results: We report our Burgos ten-step eltrombopag tapering scheme with which we have achieved an elevated percentage rate of success (70.3%) in discontinuing treatment. Conclusions: We hope this protocol may help successfully taper and discontinue TPO-RAs in daily clinical practice. Full article
(This article belongs to the Special Issue Immune Thrombocytopenia (ITP): Diagnosis and Treatment)
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Current Concepts in the Diagnosis and Management of Adult Primary Immune Thrombocytopenia: Our Personal View
by
Tomás José González-López
,
Adrian Newland
and
Drew Provan
Medicina 2023, 59(4), 815; https://doi.org/10.3390/medicina59040815 - 21 Apr 2023
Viewed by 833
Abstract
Primary immune thrombocytopenia (ITP) is an acquired blood disorder that causes a reduction in circulating platelets with the potential for bleeding. The incidence of ITP is slightly higher in adults and affects more women than men until 60 years, when males are more [...] Read more.
Primary immune thrombocytopenia (ITP) is an acquired blood disorder that causes a reduction in circulating platelets with the potential for bleeding. The incidence of ITP is slightly higher in adults and affects more women than men until 60 years, when males are more affected. Despite advances in basic science, primary ITP remains a diagnosis of exclusion. The disease is heterogeneous in its clinical behavior and response to treatment. This reflects the complex underlying pathophysiology, which remains ill-understood. Platelet destruction plays a role in thrombocytopenia, but underproduction is also a major contributing factor. Active ITP is a proinflammatory autoimmune disease involving abnormalities within the T and B regulatory cell compartments, along with several other immunological abnormalities. Over the last several years, there has been a shift from using immunosuppressive therapies for ITP towards approved treatments, such as thrombopoietin receptor agonists. The recent COVID-19 pandemic has hastened this management shift, with thrombopoietin receptor agonists becoming the predominant second-line treatment. A greater understanding of the underlying mechanisms has led to the development of several targeted therapies, some of which have been approved, with others still undergoing clinical development. Here we outline our view of the disease, including our opinion about the major diagnostic and therapeutic challenges. We also discuss our management of adult ITP and our placement of the various available therapies. Full article
(This article belongs to the Special Issue Immune Thrombocytopenia (ITP): Diagnosis and Treatment)
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