Thrombopoietin receptor agonists to control immune thrombocytopenia in patients with active lymphoma

Primary immune thrombocytopenia (pITP) is characterized by isolated thrombocytopenia (platelet count <100 9 109/l) in the absence of other causes or diseases, while secondary ITP (sITP) includes all ITP-like syndromes, associated with other disorders, such as chronic lymphoproliferative disorders (Rodeghiero et al, 2009). Approximately 30% of sITP are present at the diagnosis of a lymphoid tumour or occur during the disease (Liebman, 2007). Diagnosis of sITP in presence of lymphoproliferative disorders may be difficult because many confounding events (i.e. chemotherapy) can variably reduce the platelet count. The increase in bone marrow megakaryocytes, the rapidity of platelet decrease and the absence of previous recent cytotoxic treatments remain the most reliable diagnostic criteria (Visco & Rodeghiero, 2009; Gonzalez-Lopez et al, 2017). A correct diagnosis and an adequate therapeutic approach may prevent life-threatening bleeding and avoid undue toxicity.