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Interpretation of American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia(the part for children)

  

  1. Department of Pediatric Hematology,Tongji Hospital Affiliated to Tongji Medical College of HUST, Wuhan  430030,China
  • Online:2021-02-06 Published:2021-03-19

《2019年美国血液学会免疫性血小板减少症指南》儿童部分解读

  

  1.  华中科技大学同济医学院附属同济医院儿童血液科,湖北  武汉  430030

Abstract: Immune thrombocytopenia(ITP) is an acquired autoimmune disorder characterized by a low platelet count resulting from platelet destruction and impaired platelet production. The incidence of ITP is estimated to be 2 to 5 per 100 000 persons in the general population. The latest guidelines offer first-and second-line treatments for ITP in children. The first-line treatment options include observation,outpatient visit,corticosteroids,anti-D immunoglobulin and intravenous injection of immunoglobulin(IVIG). The second-line treatments include rituximab,thrombopoietin receptor agonists(TPO-RA) and splenectomy. There are other third-line treatments,for which the guidelines do not make clear recommendations.

Key words: American Society of Hematology, child, immune thrombocytopenia, guideline

摘要: 免疫性血小板减少症(immune thrombocytopenia,ITP)是一种获得性自身免疫性疾病,其主要机制为血小板破坏过多及生成受阻导致血小板计数减少。一般人群中ITP的发病率为2/10万~5/10万。新版指南提供了儿童ITP一线和二线治疗方案,一线治疗方案包括观察、门诊、皮质类固醇、抗D免疫球蛋白、静脉注射免疫球蛋白(intravenous immunoglobulin,IVIG),二线治疗方案包括利妥昔单抗、血小板生成素受体激动剂(thrombopoietin receptor agonists,TPO-RA)、脾切除术。另有一些三线药物治疗但指南未给出明确建议。

关键词: 美国血液学会, 儿童, 免疫性血小板减少症, 指南