Chronic refractory ITP in children: beyond splenectomy

Idiopathic (or immune) thrombocytopenic purpura (ITP) is a relatively common hematologic condition, but one that the hematology community has failed to reach a consensus on with regard to treatment. In patients with chronic refractory ITP, there is even less agreement about treatment approaches, as this population represents a small, but challenging, fraction of the total cases of ITP. The aim of this article is to review the treatment options available for children with chronic refractory ITP, including a review of the benefits versus risks, rate of remission, and areas of ongoing and future research.