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Updated: Jul 16, 2025

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The role of T cells and myeloid-derived suppressor cells in refractory immune thrombocytopenia

Karina Yazdanbakhsh1, Drew Provan2, John W Semple3,4,5

  • 1Laboratory of Complement Biology, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA.

British Journal of Haematology
|September 22, 2023
PubMed

Immune thrombocytopenia (ITP) is characterized by a dysregulated immune response against platelets, affecting both their destruction and production. A role for an abnormal T-cell compartment has been established in ITP pathogenesis and treatments that increase platelet counts in patients with ITP have shown improvements in T-cell profiles. On the other hand, patients who were refractory to treatment appear to retain the T-cell abnormalities as before. Myeloid-derived suppressive cells (MDSCs) are also emerging as key contributors to the immune pathology of ITP and response to treatment. In this review, we will discuss how various treatments affect the T-cell and MDSC compartments in ITP. The review will focus on studies that have examined the underlying mechanisms and/or genetic basis responsible for refractoriness to a given treatment and highlight remaining challenges in identifying factors and mechanisms to predict response to treatment.

Keywords:
T regulatorymyeloid-derived suppressive cellsrefractory immune thrombocytopeniaresponder/non-responderrole of T cellsthrombopoietin receptor agonists

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