Lessons from series of treated ITP
The overall survival following the traditional approach (corticosteroids and splenectomy) in severe ITP is unknown
Deaths due to lethal infections might exceed deaths due to bleeding (both 1-2 % of the initial cohort)
Morbidity and mortality are “concentrated” in refractory patients
Refractory patients with persistent severe ITP and bleeding are at high risk from hemorrhage and require treatment despite some toxicity
As less toxic treatments become available, the risk/benefit ratio will make treatment indicated in less severe patients and the QoL should become a major issue in ITP