{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:01:56Z","timestamp":1777942916323,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Children with immune thrombocytopenia (ITP) may have an increased risk of perioperative bleeding. However, current pediatric ITP guidelines do not address this management setting. We aimed to describe perioperative management and outcomes in pediatric patients with ITP by platelet count, type of surgery, and ITP\u2010directed treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients with ITP ages 0\u201324 years who underwent tooth extraction, tonsillectomy and adenoidectomy, appendectomy, and\/or splenectomy at six centers in the United States and Canada between 2019 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010six patients underwent 61 surgeries. Hematology was consulted prior to 89% (49\/55) of procedures. Perioperative ITP\u2010directed treatment was prescribed for 52% (32\/61) of surgeries. Perioperative treatment was prescribed to 83% (15\/18) of patients with preoperative platelet counts &lt;50\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L, compared with 53% (9\/17) with platelet counts 50\u201399\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L, and 33% (8\/24) with platelet counts \u2265100\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L. At the time of surgery, 93% (56\/60) of patients had platelet counts \u226550\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L. There were two perioperative bleeding events (3%; 2\/58), including major bleeding in a patient with a platelet count of 1\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L where hematology was not involved in perioperative management. Medication side effects were reported in 7% (3\/43) of patients receiving ITP\u2010directed therapies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this study of 61 surgeries, 52% of pediatric patients with ITP were given perioperative ITP\u2010directed treatments. Treatment was prescribed for almost half of the patients with an initial platelet count \u226550\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L. Perioperative bleeding risk appears to be low in pediatric ITP under current management practices.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70283","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T07:10:33Z","timestamp":1774595433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Strategies and Outcomes in Pediatric Patients With Immune Thrombocytopenia Undergoing Surgical Procedures: A Multicenter Study"],"prefix":"10.1002","volume":"73","author":[{"given":"Matthew","family":"Ross","sequence":"first","affiliation":[{"name":"NYU Grossman School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lia","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology\u2010Oncology NYU Grossman Long Island School of Medicine  Mineola New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristyn","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Pediatrics NYU Grossman School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Charland","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Children's Hospital of Eastern Ontario Research Institute  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour El","family":"Haouzi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology CHU Sainte\u2010Justine, Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praharsha","family":"Konde","sequence":"additional","affiliation":[{"name":"Division of Hematology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Meuler","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Wisconsin, USA  Milwaukee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin","family":"Montcrieff","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ukropina","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Children's Hospital of Eastern Ontario Research Institute  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Wang","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at UPENN  Philadelphia Pennsylvania 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