Idiopathic thrombocytopenic purpura: Current concepts in pathophysiology and management

Roberto Stasi; Maria Laura Evangelista; Elisa Stipa; Francesco Buccisano; Adriano Venditti; Sergio Amadori

doi:10.1160/TH07-08-0513

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 99(01): 4-13
DOI: 10.1160/TH07-08-0513

Review Article

Schattauer GmbH

Idiopathic thrombocytopenic purpura: Current concepts in pathophysiology and management

Roberto Stasi

¹Department of Medical Sciences, Ospedale „Regina Apostolorum“, Albano Laziale, Italy

,

Maria Laura Evangelista

¹Department of Medical Sciences, Ospedale „Regina Apostolorum“, Albano Laziale, Italy

,

Elisa Stipa

²Division of Hematology, Ospedale S. Eugenio, Rome, Italy

,

Francesco Buccisano

³Department of Hematology, “Tor Vergata” University Hospital, Rome, Italy

,

Adriano Venditti

³Department of Hematology, “Tor Vergata” University Hospital, Rome, Italy

,

Sergio Amadori

³Department of Hematology, “Tor Vergata” University Hospital, Rome, Italy

› Author Affiliations

Abstract

Summary

Idiopathic thrombocytopenic purpura (ITP) is characterized by a low platelet count, which is the result of both increased platelet destruction and insufficient platelet production. Although the development of autoantibodies against platelet glycoproteins remains central in the pathophysiology of ITP, several abnormalities involving the cellular mechanisms of immune modulation have been identified. Conventional treatments for ITP aim at reducing platelet destruction, either by immunosuppression or splenectomy. Two new thrombopoietic agents, AMG 531 and eltrombopag, have been used in clinical trials to stimulate platelet production in ITP patients not responsive to standard treatments. These new molecules bear no structural resemblance to thrombopoietin, but still bind and activate the thrombopoietin receptor. This review will focus on the pathophysiology and treatment of ITP in adults, highlighting recent advances in both fields.

Keywords

Thrombocytopenia - platelet immunology - immunity

Full Text

References

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