Francesco Rodeghiero1, Silvia Cantoni2, Giuseppe Carli3, Monica Carpenedo4, Valentina Carrai5, Federico Chiurazzi6, Valerio De Stefano7, Cristina Santoro8, Sergio Siragusa9, Francesco Zaja10 and Nicola Vianelli11.
1 Fondazione Progetto Ematologia, Vicenza.
2 Dipartimento di Ematologia e Oncologia, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano, Ospedale Niguarda, Milano.
3 Divisione Ematologia, Ospedale S. Bortolo Vicenza, Vicenza.
4 UO Ematologia e Trapianto, Azienda Ospedaliera "S. Gerardo", Monza.
5 A.O.U. Careggi - Ematologia, Firenze.
6 Dipartimento di Ematologia e Trapianto di Midollo, Ospedale Universitario Federico II, Napoli.
7 Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore – Fondazione Policlinico A. Gemelli IRCCS, Roma.
8 Ematologia, Azienda Ospedaliera Universitaria Policlinico Umberto I, Roma.
9 Dipartimento Promise, Università degli Studi di Palermo, Palermo.
10 Dipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste.
11 Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
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The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context. It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients.
Probably, the greatest risk to avoid for a patient with suspected, ongoing or relapsed ITP - that is not severe enough to place him or her at risk for major bleeding - is to be infected in non-hospital and hospital healthcare settings. This risk must be carefully considered when adapting the diagnostic and therapeutic approach.
in detail, the document first addresses the appropriate management for COVID-19
negative patients with newly diagnosed ITP or who experience a relapse of
previous ITP, according to first and second-line of treatment and then the
management of COVID-19 positive patients according to their severity, from
paucisymptomatic to those requiring admission to Intensive Cure Units (ICU).
The pros and cons of the different treatments required to correct platelet
count are discussed, as are some specific situations, including chronic ITP,
splenectomy, thromboembolic complication and anti COVID-19 vaccination.
Thrombocytopenia and COVID-19
Management of COVID-19 Negative Patients WITH Newly Diagnosed ITP or Who Experience A Relapse of Previous ITP
Management of COVID-19 Positive Patients with Newly Diagnosed ITP or Who Experience a Relapse of Previous ITP
Management of Patients with Chronic ITP
Measures to Prevent Contagion