{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:14:10Z","timestamp":1790957650659,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Immune thrombocytopenia (ITP) in children is a relatively mild and self\u2010limited disorder with the majority of children demonstrating normalization of platelet count by 12\u2009months from diagnosis. Because of this, many children with ITP can be observed without the need for treatment. When needed, treatment with either intravenous immunoglobulin (IVIG) or corticosteroids is highly effective (&gt;80% IVIG and &gt;95% corticosteroids). For those children who require second\u2010line therapies, response rates of &gt;60% are seen with both the thrombopoietin\u2010receptor agonists and rituximab. Despite this, some children will have \u2018refractory\u2019 ITP (rITP) with poor or transient responses to platelet\u2010raising therapies. Here, we review the clinical features of rITP in children, outline proposed classifications and explore potential predictors for children with rITP.<\/jats:p>","DOI":"10.1111\/bjh.19072","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T09:14:01Z","timestamp":1693300441000},"page":"17-22","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A proposal for new definition (s) and management approach to paediatric refractory <scp>ITP<\/scp>: Reflections from the Intercontinental <scp>ITP<\/scp> Study Group"],"prefix":"10.1111","volume":"203","author":[{"given":"Cindy","family":"Neunert","sequence":"first","affiliation":[{"name":"Vagelos College of Physicians and Surgeons Columbia University Medical School  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja M. J.","family":"Heitink\u2010Polle","sequence":"additional","affiliation":[{"name":"Princess Maxima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele P.","family":"Lambert","sequence":"additional","affiliation":[{"name":"Division of Hematology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine at UPENN  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426\u2010200411000\u201000007"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56120667"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185\u2010020\u201002977\u20109"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1179\/102453309X12473408860343"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102018\u201002\u2010830844"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017010660"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620720912992"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29447"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201007\u2010162503"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102010\u201008\u2010302984"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010016\u20102738\u20103"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30173"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26736"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26003"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25479"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15232"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15125"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12524"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153403"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426\u2010199707000\u201000006"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001836"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18732"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101599146"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.19072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T18:37:04Z","timestamp":1700764624000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.19072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,29]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/bjh.19072"],"URL":"https:\/\/doi.org\/10.1111\/bjh.19072","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,29]]},"assertion":[{"value":"2023-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}