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American Journal of the Medical Sciences:
doi: 10.1097/MAJ.0b013e31827f4dd1
Clinical Investigation

Management of Primary Immune Thrombocytopenia, 2012: A Survey of Oklahoma Hematologists-Oncologists

Lu, Kaelyn H. BS; George, James N. MD; Vesely, Sara K. PhD; Terrell, Deirdra R. PhD

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Abstract

Background:

Management options for patients with primary immune thrombocytopenia (ITP) have increased, and treatment of patients with ITP has changed during the past 10 years.

Methods:

To document current practice and to determine how current practice is related to recommendations of 2 recent practice guidelines for ITP, an International Consensus report and an American Society of Hematology (ASH) guideline, the authors surveyed practicing hematologists-oncologists in Oklahoma. Surveys were specific for children or adults. Each survey had 3 questions describing patients with a new diagnosis and patients who had not achieved remission with initial treatment. Questions were adapted from the clinical scenarios of the ASH guideline.

Results:

Twelve (92%) Oklahoma pediatric hematologists-oncologists responded; 82 (81%) Oklahoma adult hematologists-oncologists responded. For a child with a new diagnosis of ITP, a platelet count of 8000/µL and minor bleeding, 5 (42%) hematologists-oncologists selected observation without drug treatment (recommended by both guidelines). For an adult with a platelet count of 9000/µL who had failed to respond to initial treatment with corticosteroids and IVIg, 32 (39%) selected splenectomy (recommended by the ASH guideline); 30 (37%) selected rituximab and 13 (16%) selected thrombopoietin-receptor agonists (both recommended by the International Consensus report). Hematologists-oncologists who had more years in practice were more likely to select splenectomy (P = 0.047).

Conclusions:

In a time of changing management for patients with ITP, these data document reported current management in Oklahoma and provide a basis for serial comparisons across time and for comparisons with other regions and comparison of management with patient outcomes.

Copyright © 2013 by the Southern Society for Clinical Investigation

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