Understanding Chronic ITP

What is chronic immune thrombocytopenia?

Chronic immune thrombocytopenia (cITP) (also known as chronic immune thrombocytopenic purpura) is a rare blood condition. People who have it do not have enough platelets in their blood. Platelets are blood cells that help stop bruising and bleeding when you get hurt. This low number of platelets can lead to easy bruising and bleeding.

 

Even though it may be scary to be diagnosed with cITP, there is good news:

  • It’s not cancer
  • It’s not contagious
  • It’s often managed with treatment

What are the different ways cITP can affect me?

In people with cITP, platelets drop to dangerously low levels. Why does this happen?

  • The immune system mistakenly attacks and destroys healthy platelets, which grow in the bone marrow
  • The body doesn’t create enough platelets to make up for the platelet destruction

cITP treatments aim to tackle either or both of these issues.

What is the difference between acute ITP and chronic ITP?

Acute ITP

When you are first diagnosed with ITP (immune thrombocytopenia), your health care team assumes that the ITP is acute ITP, which lasts less than 6 months. They may treat you with treatments that get platelets up quickly, such as steroids or intravenous immunoglobulin (IVIg).

 

Chronic ITP

Chronic ITP is ITP that lasts 6 months or longer. It is the most common form of ITP in adults.

 

If you have chronic ITP, you may have seen your platelets rise with earlier ITP treatments, only to be disappointed when they fell again once treatment was stopped.

 

PROMACTA® (eltrombopag) is a treatment for people with chronic ITP. It may help boost platelets and maintain stable platelet counts after other treatments have not worked well enough or have caused too many side effects.

 

Below are other ITP treatments you may come across as you learn about and explore different treatment options.

Common ITP treatments

Acute ITP

Corticosteroids

Most ITP patients start with a round of corticosteroids, also known as steroids. Steroids raise platelets quickly and can be taken in a pill. Unfortunately, steroids can also have side effects, including insomnia, weight gain, and mood swings. That is why they are not meant to be taken long term.

 

IVIg

IVIg is also an option to raise platelet counts quickly. IVIg is an infusion given with a needle and requires sitting still for some time while the medicine goes into a vein.

Chronic ITP

Platelet boosters

Instead of trying to stop the body from destroying platelets, platelet boosters, aka thrombopoietin receptor agonists (TPO-RA), encourage the body to make more of them. Currently, there are 3 US Food and Drug Administration (FDA)-approved TPO-RAs: PROMACTA, which comes in a tablet or as an oral suspension, and 2 others, one that comes in just a tablet and another that is given as an injection.

 

Chemotherapy

Although ITP is not a form of cancer, there are certain cancer therapies that may help alter the immune system so it is less likely to attack healthy platelets.

 

These therapies sometimes help raise platelet levels but are not FDA-approved treatments for ITP.

 

Splenectomy

A splenectomy is surgery to remove the spleen. While no longer a common approach, some doctors believe removing the spleen can help people with chronic ITP.