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Low platelet count (PC; &lt;20\u201330\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L) is generally indicative of increased risk of bleeding. However, PC and bleeding events cannot be fully correlated; many other patient\u2010 and disease\u2010related factors are thought to contribute to increased bleeding risk. Furthermore, even though ITP patients have thrombocytopenia and are at increased risk of bleeding, ITP also carries higher risk of thrombotic events. Factors like older age and certain ITP treatments are associated with increased thrombotic risk. Women's health in ITP requires particular attention concerning haemorrhagic and thrombotic complications. Management of bleeding\/thrombotic risk, and eventually antithrombotic therapies in ITP patients, should be based on individual risk profiles, using a tailored, patient\u2010centric approach. Currently, evidence\u2010based recommendations and validated tools are lacking to support decision\u2010making and help clinicians weigh risk of bleeding against thrombosis. Moreover, evidence is lacking about optimal PC for achieving haemostasis in invasive procedures settings. Further research is needed to fully define risk factors for each event, enabling development of comprehensive risk stratification approaches. This review discusses risk\u2010based and individualised management of bleeding and thrombosis risk in adults with primary ITP.<\/jats:p>","DOI":"10.1111\/ejh.14154","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T11:08:47Z","timestamp":1702465727000},"page":"504-515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Risk\u2010based and individualised management of bleeding and thrombotic events in adults with primary immune thrombocytopenia (<scp>ITP<\/scp>)"],"prefix":"10.1111","volume":"112","author":[{"given":"Catherine","family":"Lambert","sequence":"first","affiliation":[{"name":"Hemostasis and Thrombosis Unit, Division of Hematology Cliniques universitaires Saint\u2010Luc  UCLouvain, Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Maitland","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology University of Virginia Medical Center  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Ghanima","sequence":"additional","affiliation":[{"name":"Department of Hemato\u2010oncology, \u00d8stfold Hospital Oslo University  Oslo Norway"},{"name":"Department of Hematology, Institute of Clinical Medicine Oslo University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201007\u2010162503"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm6020016"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000574"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001446"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-582346"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102016\u201003\u2010603365"},{"key":"e_1_2_11_10_1","unstructured":"NewlandA HillQ MorganM et al.Making the Right Choices in ITP Management and Care: A Shared Decision Making Toolkit for Patients.2021. 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