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Understanding the Disease

Chronic ITP

Understanding the Disease

What is chronic immune thrombocytopenia (ITP)?

Chronic immune thrombocytopenia (also known as chronic immune thrombocytopenic purpura) is a rare blood disorder. People who have it do not have enough platelets in their blood. Without platelets, it is harder for the blood to clot. This can lead to bruising and bleeding.

 

It can be frightening to be diagnosed with chronic ITP, but there is good news:

  • It’s not cancer
  • It’s not contagious
  • It may be managed with treatment

What happens in chronic ITP?

In people with chronic ITP, platelets may drop to dangerously low levels when their:

  • immune system mistakenly attacks healthy platelets
  • spleen traps too many platelets, taking them out of the blood
  • body doesn’t make enough platelets to make up for the platelet destruction
In the disease chronic ITP, healthy platelets are destroyed and fewer platelets are made.

Chronic ITP treatments aim to tackle one or more of these issues.

What is the difference between acute ITP and chronic ITP?

Acute ITP

When you are first diagnosed with ITP, your health care team operates under the assumption that the ITP is acute ITP, or ITP that lasts for less than 6 months. They may treat you with acute ITP treatments that get platelets up quickly, such as steroids or 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 acute ITP treatments but got disappointed when they fell again once treatment was stopped. 

 

PROMACTA® (eltrombopag) is a treatment for people with chronic ITP. It may help boost your 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 on your journey.

Common ITP treatments

Acute ITP

Steroids

Most ITP patients start with a round of steroids. Steroids boost platelets quickly and can be taken in a pill or injectable formulation. Unfortunately, steroids can also have a lot of side effects, including insomnia, weight gain, and mood disturbances. That is why they are not meant to be taken long term.

 

Intravenous immunoglobulin (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 the vein.

Chronic ITP

Platelet boosters

Instead of trying to stop the body from destroying platelets, platelet boosters (aka thrombopoietin receptor agonists or platelet growth factors) encourage the body to make more of them. Their side effects are generally mild and they can be taken long term. Currently, there are 2 types of platelet boosters: PROMACTA® (eltrombopag), which comes in a tablet, and one that is given as an injection under the skin.

 

Chemotherapy

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

 

Chemotherapy sometimes helps raise platelet levels.

 

Chemotherapy is not an FDA-approved treatment for ITP but it is part of the American Society of Hematology guidelines.

 

Splenectomy

A splenectomy is surgery to remove the spleen. While doctors would not normally remove a healthy organ, the spleen sometimes traps too many platelets, so taking it out can help people with chronic ITP.