Management of Primary Immune Thrombocytopenia: Turkish Modified Delphi-Based Consensus Statement for Special Considerations

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dc.contributor.authorUmit, Elif Gulsum
dc.contributor.authorDemir, Ahmet Muzaffer
dc.contributor.authorAr, Muhlis Cem
dc.contributor.authorAyer, Mesut
dc.contributor.authorAyli, Meltem
dc.contributor.authorKarakus, Volkan
dc.contributor.authorKaya, Emin
dc.date.accessioned2026-04-04T13:30:49Z
dc.date.available2026-04-04T13:30:49Z
dc.date.issued2024
dc.departmentİnönü Üniversitesi
dc.description.abstractObjective: Primary immune thrombocytopenia (ITP) is an acquired disorder of platelets with a complex and unclear mechanism of increased immune destruction or impaired production of platelets. While the management of ITP is evolving, there is still a need for guidance, particularly in certain circumstances such as pregnancy, emergencies, or patients requiring co-medications. We aimed to determine the tendencies of hematologists in T & uuml;rkiye in the event of such special considerations. Materials and Methods: Applying a modified Delphi method, the Turkish National ITP Working Group, founded under the auspices of the Turkish Society of Hematology, developed a questionnaire consisting of statements regarding pregnancy, emergencies, and circumstances requiring co-treatment with antiaggregants or anticoagulants. A total of 107 hematologists working in university or state hospitals voted for their agreement or disagreement with the statements for two sequential rounds. Results: The participating hematologists reached an agreement on starting treatment for pregnant patients with platelets of less than 30x109/L 9 /L and delivery either vaginally or by cesarean section being safe at platelet counts above 50x109/L. 9 /L. For emergencies and the rescue management of ITP, the panel agreed against the use of high-dose corticosteroids alone, preferring combinations with transfusions or intravenous immunoglobulin. For patients who require interventions, platelet counts of >50x109/L 9 /L were regarded as safe for low-risk procedures as well as co-treatment with antiplatelets or anticoagulants. Conclusion: As the National ITP Study Group, we have observed the need to increase the practice guidance regarding patients with primary ITP requiring additional treatments including invasive interventions and co-treatments for coagulation. Decisions on the management of ITP during pregnancy should be individualized. There is a lack of consensus on the thresholds of platelet counts as well as co-morbidities and co-medications. This lack of consensus may be due to variations in practices.
dc.description.sponsorshipAbdi Idot;brahim Pharmaceuticals
dc.description.sponsorshipThis study was financially supported by Abdi & Idot;brahim Pharmaceuticals.
dc.identifier.doi10.4274/tjh.galenos.2024.2024.0101
dc.identifier.endpage145
dc.identifier.issn1300-7777
dc.identifier.issn1308-5263
dc.identifier.issue3
dc.identifier.orcid0000-0001-8605-8497
dc.identifier.orcid0000-0003-1977-0104
dc.identifier.pmid38801066
dc.identifier.scopus2-s2.0-85202791501
dc.identifier.scopusqualityQ3
dc.identifier.startpage141
dc.identifier.trdizinid1315674
dc.identifier.urihttps://doi.org/10.4274/tjh.galenos.2024.2024.0101
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1315674
dc.identifier.urihttps://hdl.handle.net/11616/108389
dc.identifier.volume41
dc.identifier.wosWOS:001301331900002
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakTR-Dizin
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherGalenos Publ House
dc.relation.ispartofTurkish Journal of Hematology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectAdult primary immune thrombocytopenia
dc.subjectManagement
dc.subjectDelphi method
dc.subjectSpecial considerations
dc.titleManagement of Primary Immune Thrombocytopenia: Turkish Modified Delphi-Based Consensus Statement for Special Considerations
dc.typeArticle

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