Individualized treatment for immune thrombocytopenia: predicting bleeding risk

Treatment of patients with immune thrombocytopenia (ITP) is often directed at increasing the platelet count and preventing significant hemorrhage even when there is minimal bleeding present. This approach, however, requires that a large number of patients receive prophylactic treatment to prevent major bleeding events. Identification of initial risk factors for development of severe bleeding would allow for more directed and personalized therapy. This review provides a summary of the current literature with the intent to explore various clinical and laboratory risk factors for severe bleeding including mucosal bleeding, platelet count, and aspects of platelet function.