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Controversy exists regarding management of children newly diagnosed with immune thrombocytopenic purpura (ITP

Key Points• Severe thrombocytopenia is rare and major hemorrhage is uncommon in children with persistent and chronic ITP.• In children with persistent or chronic ITP, there is a trend toward reserving drug therapy for those experiencing significant bleeding. /L was uncommon (7%, 7%, and 4%, respectively). Remission occurred in 37% of patients between 28 days and 6 months, 16% between 6 and 12 months, and 24% between 12 and 24 months. There were no reports of intracranial hemorrhage, and the most common site of bleeding was skin. In patients with severe thrombocytopenia we observed a trend toward more drug treatment with increasing number of bleeding sites. Our data support that ITP is a benign condition for most affected children and that major hemorrhage, even with prolonged severe thrombocytopenia, is rare. (Blood. 2013;121(22):4457-4462)