Efficient adaptation of high‐quality international guidelines for Chinese children with primary immune thrombocytopenia

Abstract

How to cite this article: Liu Y, Wu R. Efficient adaptation of high-quality international guidelines for Chinese children with primary immune thrombocytopenia.

Australian and New Zealand consensus guideline for paediatric newly diagnosed immune thrombocytopaenia endorsed by Australian New Zealand Children's Haematology and Oncology Group

“…It is suggested prior to corticosteroid treatment in NDITP in China and Italy despite the lack of strong evidence. 12,20 Typically, the bone marrow evaluation in a child with NDITP demonstrates normal trilineage haematopoiesis. It may be appropriate in those not responding to initial treatment, where splenectomy is considered, or if other abnormalities are detected in the blood count or morphology (GRADE C).…”

“…Dose recommendations for prednisolone range from 2 to 4 mg/kg/day in divided doses for a duration of 4-14 days. 9,10,12,14,27 There has been no direct comparison between low-dose (2 mg/kg/day) and high-dose (4 mg/kg/ day) prednisolone therapy. 9,14 Longer-term (>1-3 week course) corticosteroids should be avoided in children due to potential sideeffects.…”

“…Bone marrow analysis is not recommended in paediatric patients with typical presentations of NDITP in most centres 9–11,14,22,23 (GRADE 2C). It is suggested prior to corticosteroid treatment in NDITP in China and Italy despite the lack of strong evidence 12,20 . Typically, the bone marrow evaluation in a child with NDITP demonstrates normal trilineage haematopoiesis.…”

“…Various corticosteroid regimens have shown to be effective with each guideline differing in their approach. Dose recommendations for prednisolone range from 2 to 4 mg/kg/day in divided doses for a duration of 4–14 days 9,10,12,14,27 . There has been no direct comparison between low‐dose (2 mg/kg/day) and high‐dose (4 mg/kg/day) prednisolone therapy 9,14 .…”

“…The international consensus guidelines (ICGs) were most recently updated in 2019 9 . Chinese, British and Italian guidelines were also reviewed last updated in 2021 and 2008, respectively 12–14 . Although all the guidelines commented on paediatric management of NDITP, not all were paediatric‐specific.…”