{
  "abstract": "Background: Since publication of the American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia (ITP), new clinical trials have been completed, and new treatments have become available.\n\nObjective: These evidence-based guidelines from the American Society of Hematology (ASH) are a focused update of the 2019 ASH ITP guidelines, centering on treatment of adults with primary ITP.\n\nMethods: ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The University of Oklahoma supported the guideline development process, including updating or performing systematic evidence reviews (up to 19 July 2025). The panel prioritized clinical questions and outcomes according to their importance to clinicians and patients and identified areas with new data or in which application of new methods would be of benefit. The panel used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks and the GRADE framework for multiple comparisons, to assess evidence and make recommendations, which were subject to public comment.\n\nResults: The panel agreed on recommendations for adults with primary ITP regarding initial therapy and second-line therapy for patients who failed first-line corticosteroids. The panel also issued good practice statements on thrombopoietic agent switching and splenectomy.\n\nConclusions: Novel recommendations of these guidelines include (1) initial therapy with a combination of rituximab plus corticosteroids or a thrombopoietic agent plus corticosteroids rather than corticosteroids alone (conditional recommendation) and (2) a thrombopoietic agent (strong recommendation) or rituximab (conditional recommendation) for patients who failed first-line corticosteroids.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA",
    "Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA",
    "Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Campus, Oklahoma City, OK",
    "Department of Medicine, McMaster University, Hamilton, ON, Canada",
    "Michael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada",
    "Department of Internal Medicine, Université Bourgogne Europe, Dijon, France",
    "Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France",
    "Department of Pediatrics, Weill Cornell Medical College, Cornell University, New York, NY",
    "Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain",
    "Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard Medical School, Boston, MA",
    "Miami Cancer Institute, Baptist Health South Florida, Coral Gables, FL",
    "Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH",
    "Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia",
    "Medical Faculty, University of Belgrade, Belgrade, Serbia",
    "Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Columbia University Irving Medical Center, New York, NY",
    "Division of Hematology/Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA",
    "Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ",
    "Albany, GA",
    "Topeka, KS"
  ],
  "article_type": "other",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Adam Cuker"
    },
    {
      "affs": [
        2
      ],
      "name": "Deirdra R. Terrell"
    },
    {
      "affs": [
        2
      ],
      "name": "Honieh Sowdagar"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Donald M. Arnold"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Sylvain Audia"
    },
    {
      "affs": [
        7
      ],
      "name": "James B. Bussel"
    },
    {
      "affs": [
        8
      ],
      "name": "Tomás José González-López"
    },
    {
      "affs": [
        9
      ],
      "name": "Rachael F. Grace"
    },
    {
      "affs": [
        10
      ],
      "name": "Camila Masias"
    },
    {
      "affs": [
        11
      ],
      "name": "Keith R. McCrae"
    },
    {
      "affs": [
        12,
        13
      ],
      "name": "Mirjana Mitrovic"
    },
    {
      "affs": [
        14
      ],
      "name": "Cindy Neunert"
    },
    {
      "affs": [
        15
      ],
      "name": "Sandhya R. Panch"
    },
    {
      "affs": [
        16
      ],
      "name": "Surbhi Shah"
    },
    {
      "affs": [
        17
      ],
      "name": "Brenda Shy"
    },
    {
      "affs": [
        18
      ],
      "name": "Jessica VandeVelde"
    },
    {
      "affs": [
        1
      ],
      "name": "Douglas B. Cines"
    },
    {
      "affs": [
        2
      ],
      "name": "Sara K. Vesely"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e3bqkw5g4defb.bib",
  "cited_by": 1,
  "doi": "10.1182/bloodadvances.2026021269",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696133/",
  "id": "e3bqkw5g4defb",
  "issns": [
    "2473-9529",
    "2473-9537"
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  "landing_url": "https://doi.org/10.1182/bloodadvances.2026021269",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Guidelines"
    ],
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      "openalex",
      "2720|Platelet Disorders and Treatments"
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  "openalex": "W7203771956",
  "pdf_url": "https://ashpublications.org/bloodadvances/article-pdf/10/20/7076/2595557/blooda_adv-2026-021269-main.pdf",
  "pmcid": "PMC13696133",
  "pmid": "42617047",
  "published": "2026-08-21",
  "publisher": "The American Society of Hematology",
  "ris": "https://research.draconitic.com/paper/e3bqkw5g4defb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:32Z",
      "native_id": "PMC13696133",
      "source": "pmc",
      "url": "https://doi.org/10.1182/bloodadvances.2026021269"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Platelet Disorders and Treatments",
      "subfield": "general"
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  ],
  "title": "American Society of Hematology 2026 guidelines for immune thrombocytopenia: initial and second-line therapy for adults with primary ITP",
  "title_text": "American Society of Hematology 2026 guidelines for immune thrombocytopenia: initial and second-line therapy for adults with primary ITP",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:31Z",
  "url": "https://research.draconitic.com/paper/e3bqkw5g4defb",
  "venue": "Blood Advances",
  "versions": []
}