2b44de72b69bb812f7eb0814d0311b8d jcm-12-06422.pdf 793198271212970c2a540bb97fb15b14c84f3e29 jcm-12-06422.pdf be25d277296bdfb3abfdd14a4a6364f88939bcfc7054f49c48985d7233062fc9 jcm-12-06422.pdf Title: Recommendations for the Clinical Approach to Immune Thrombocytopenia: Spanish ITP Working Group (GEPTI) Subject: Primary immune thrombocytopenia (ITP) is a complex autoimmune disease whose hallmark is a deregulation of cellular and humoral immunity leading to increased destruction and reduced production of platelets. The heterogeneity of presentation and clinical course hampers personalized approaches for diagnosis and management. In 2021, the Spanish ITP Group (GEPTI) of the Spanish Society of Hematology and Hemotherapy (SEHH) updated a consensus document that had been launched in 2011. The updated guidelines have been the reference for the diagnosis and management of primary ITP in Spain ever since. Nevertheless, the emergence of new tools and strategies makes it advisable to review them again. For this reason, we have updated the main recommendations appropriately. Our aim is to provide a practical tool to facilitate the integral management of all aspects of primary ITP management. Keywords: primary immune thrombocytopenia; glucocorticoids; intravenous immunoglobulins; fostamatinib; rituximab; recommendations Author: María Eva Mingot-Castellano, Mariana Canaro Hirnyk, Blanca Sánchez-González, María Teresa Álvarez-Román, Abelardo Bárez-García, Ángel Bernardo-Gutiérrez, Silvia Bernat-Pablo, Estefanía Bolaños-Calderón, Nora Butta-Coll, Gonzalo Caballero-Navarro, Isabel Socorro Caparrós-Miranda, Laura Entrena-Ureña, Luis Fernando Fernández-Fuertes, Luis Javier García-Frade, María del Carmen Gómez del Castillo, Tomás José González-López, Carlos Grande-García, José María Guinea de Castro, Isidro Jarque-Ramos, Reyes Jiménez-Bárcenas, Elsa López-Ansoar, Daniel Martínez-Carballeira, Violeta Martínez-Robles, Emilio Monteagudo-Montesinos, José Antonio Páramo-Fernández, María del Mar Perera-Álvarez, Inmaculada Soto-Ortega, David Valcárcel-Ferreiras and Cristina Pascual-Izquierdo Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Oct 10 05:47:31 2023 CEST ModDate: Tue Oct 10 05:50:12 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 29 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 455251 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- HKBJPQ+VnURWPalladioL Type 1 Custom yes yes no 10 0 CAWWLT+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 IIOSCU+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 NLENKN+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 FFAYKL+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 VWECUP+CMSY10 Type 1 Builtin yes yes no 71 0 CAMXTK+EURM10 Type 1 Builtin yes yes no 84 0 CKAQQB+URWPalladioL-BoldItal Type 1 Custom yes yes no 94 0 WPQCLC+wasy10 Type 1 Builtin yes yes no 110 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-10-22 03:54:44 CEST RepresentationInformation: jcm-12-06422.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-10-21 12:30:22 CEST Size: 455251 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 590 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Children: Item: Title: Definition and Epidemiology Destination: subsection.1.1 Item: Title: Diagnosis Destination: subsection.1.2 Item: Title: Etiology Destination: subsection.1.3 Item: Title: Outcome Destination: subsection.1.4 Item: Title: Aim of This Review Destination: subsection.1.5 Item: Title: Methods Destination: section.2 Item: Title: First-Line, Second-Line and Multirefractory ITP Treatment Destination: section.3 Children: Item: Title: First-Line Treatment Destination: subsection.3.1 Item: Title: Second-Line Treatment Destination: subsection.3.2 Item: Title: Vaccination Prior to Splenectomy Destination: subsection.3.3 Item: Title: Treatment of Multirefractory Patients Destination: subsection.3.4 Item: Title: Follow-Up of Patients with Primary ITP Scenarios and Recommendations Destination: section.4 Children: Item: Title: Hospitalization Destination: subsection.4.1 Item: Title: Follow-Up of Diseases Frequently Associated with Primary ITP Destination: subsection.4.2 Item: Title: Surgery Destination: subsection.4.3 Item: Title: Suspension of Treatment with TPO-RA Destination: subsection.4.4 Item: Title: Primary ITP in Selected Patient Populations Destination: section.5 Children: Item: Title: Pediatric Patients Destination: subsection.5.1 Item: Title: Elderly Patients Destination: subsection.5.2 Item: Title: Pregnant Patients Destination: subsection.5.3 Item: Title: Secondary ITP Destination: section.6 Item: Title: Primary ITP and Thrombosis Destination: section.7 Children: Item: Title: Pathophysiology, Risk Associated with the Treatment of Primary ITP Destination: subsection.7.1 Item: Title: Antiplatelet and Anticoagulant Treatments in the Context of Primary ITP Destination: subsection.7.2 Item: Title: ITP and COVID-19 Destination: section.8 Item: Title: Limitations Destination: section.9 Item: Title: Conclusions Destination: section.10 Item: Title: References Destination: section.A. Info: Title: Recommendations for the Clinical Approach to Immune Thrombocytopenia: Spanish ITP Working Group (GEPTI) Author: María Eva Mingot-Castellano, Mariana Canaro Hirnyk, Blanca Sánchez-González, María Teresa Álvarez-Román, Abelardo Bárez-García, Ángel Bernardo-Gutiérrez, Silvia Bernat-Pablo, Estefanía Bolaños-Calderón, Nora Butta-Coll, Gonzalo Caballero-Navarro, Isabel Socorro Caparrós-Miranda, Laura Entrena-Ureña, Luis Fernando Fernández-Fuertes, Luis Javier García-Frade, María del Carmen Gómez del Castillo, Tomás José González-López, Carlos Grande-García, José María Guinea de Castro, Isidro Jarque-Ramos, Reyes Jiménez-Bárcenas, Elsa López-Ansoar, Daniel Martínez-Carballeira, Violeta Martínez-Robles, Emilio Monteagudo-Montesinos, José Antonio Páramo-Fernández, María del Mar Perera-Álvarez, Inmaculada Soto-Ortega, David Valcárcel-Ferreiras and Cristina Pascual-Izquierdo Subject: Primary immune thrombocytopenia (ITP) is a complex autoimmune disease whose hallmark is a deregulation of cellular and humoral immunity leading to increased destruction and reduced production of platelets. The heterogeneity of presentation and clinical course hampers personalized approaches for diagnosis and management. In 2021, the Spanish ITP Group (GEPTI) of the Spanish Society of Hematology and Hemotherapy (SEHH) updated a consensus document that had been launched in 2011. The updated guidelines have been the reference for the diagnosis and management of primary ITP in Spain ever since. Nevertheless, the emergence of new tools and strategies makes it advisable to review them again. For this reason, we have updated the main recommendations appropriately. Our aim is to provide a practical tool to facilitate the integral management of all aspects of primary ITP management. 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