Bone marrow characteristics predict outcome in a multicenter cohort of primary immune thrombocytopenia patients treated with thrombopoietin analogues

It is well established that immune thrombocytopenia (ITP) results from increased immune mediatedplatelet destruction (anti-platelets antibodies, autoreactive T cells, and reduction of regulatory Tcells) along with impaired production in the bone marrow.1 The latter has been attributed to bothcellular and humoral mediators that cause suppression of megakaryocyte production andmaturation.2 Current standard first line therapy consists of corticosteroids, with or withoutintravenous Ig, achieving about 70-80% response rate. However, a consistent proportion of patientswould relapse after corticosteroid discontinuation or tapering, and requires further therapy. ...