{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T11:46:45Z","timestamp":1768823205728,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970111"],"award-info":[{"award-number":["81970111"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the effects of escalating treatment strategy in children with severe chronic immune thrombocytopenia (SCITP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, retrospective cohort study. Data from children with SCITP who received escalating treatment strategy in our center were collected between June 2017 and August 2019. The escalating strategy included three steps: Step I (six courses of high\u2010dose dexamethasone [HDD]), Step II (HDD combined with low\u2010dose rituximab), and Step III (eltrombopag).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 30 cases (18 males and 12 females) were included, with duration of immune thrombocytopenia (ITP) of 20.5 (12.0\u201396.0) months. After treatment, the remission rate was 36.7% (11\/30) and the sustained response (SR) rate was 68.2% (15\/22). The distribution (remission rates) from Step I to III was as follows: nine of 30 (33.3%, 3\/9); four of 30 (50%, 2\/4); 17\/30 (29.4%, 5\/17), respectively. In eltrombopag (Step III) cases, 47.5% (8\/17) maintained a platelet count of \u226550 \u00d7 10<jats:sup>9<\/jats:sup>\/L, 37.5% (3\/8) had dose tapering, and 25% (2\/8) have successfully discontinued the medication. The number of patients at 12, 24, and 36\u00a0months were 30, seven, and two, with a total response and remission rates of 80% (36.7%), 57.1% (28.6%), and 50% (50%), respectively. The total relapse rate was 26.7% (8\/30), and three cases from Step II and five cases from Step III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The escalating strategy for children SCITP showed an effective improvement rate with 36.7% remission and 68.2% SR, and 30% could benefit and retain SR from HDD treatment. Combined treatment with eltrombopag can reduce the relapse rate of low\u2010dose rituximab.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29006","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T15:22:04Z","timestamp":1615821724000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An escalating treatment strategy for children with severe chronic immune thrombocytopenia: Preliminary report from a single center"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-9188","authenticated-orcid":false,"given":"Lingling","family":"Fu","sequence":"first","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6759-075X","authenticated-orcid":false,"given":"Jie","family":"Ma","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Gu","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyao","family":"Ma","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunyun","family":"Wei","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengping","family":"Chen","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4030-209X","authenticated-orcid":false,"given":"Runhui","family":"Wu","sequence":"additional","affiliation":[{"name":"Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing Key Laboratory of Pediatric Hematology Oncology  Beijing China"},{"name":"National Key Discipline of Pediatrics (Capital Medical University)  Beijing China"},{"name":"Key Laboratory of Major Diseases in Children Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000112837"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019003599"},{"issue":"010","key":"e_1_2_10_6_1","first-page":"912","article-title":"[Clinical study of pulsed high\u2010dose dexamethasone treatment in 38 children with primary immune thrombocytopenic purpura]","volume":"37","author":"Ma J","year":"2016","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"e_1_2_10_7_1","first-page":"205","article-title":"Efficacy and safety of low\u2010dose rituximab combined with high\u2010dose dexamethasone pulse therapy in children with severe refractory immune thrombocytopenia\u2013analysis of 27 cases of single center data","volume":"4","author":"Long SQ","year":"2018","journal-title":"Chin J Pediatr Hematol Cancer"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2058738419872120"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2019.1678121"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-631937"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.08.036"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-704734"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.146746"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(97)70305-6"},{"issue":"1","key":"e_1_2_10_15_1","first-page":"250","article-title":"Long\u2010term follow\u2010up of refractory immune\u2010mediated thrombocytopenic purpura (ITP) patients treated with high dose dexamethasone therapy (dex)","volume":"86","author":"Nugent D","year":"1995","journal-title":"Blood"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2018.1530347"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61107-2"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(15)00114-3"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2019.1572873"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15070"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-014-1541-y"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61495-1"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.110213"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-393975"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-07-659656"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29006","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.29006","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T03:27:55Z","timestamp":1693625275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.29006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,15]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/pbc.29006"],"URL":"https:\/\/doi.org\/10.1002\/pbc.29006","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,15]]},"assertion":[{"value":"2020-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e29006"}}