Evidence map›Paper›PMID 39552264›Full record

SynthesisEuropean journal of haematology2025

Treatment of Critical Bleeds in Patients With Immune Thrombocytopenia: A Systematic Review.

Saifur R Chowdhury, Emily Sirotich, Gordon Guyatt, Daya Gill, Dimpy Modi, Laura M Venier, Syed Mahamad, Mahmudur Rahman Chowdhury, Kerolos Eisa, Carolyn E Beck and 36 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of haematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Platelet Transfusion for Patients with Cancer: An Update.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2025
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

46 authors.

Saifur R ChowdhuryMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.ORCID https://orcid.org/0000-0003-4361-0792
Emily SirotichMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Gordon GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Daya GillMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Dimpy ModiMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Laura M VenierMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Syed MahamadMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Mahmudur Rahman ChowdhuryDepartment of Public Health, North South University, Dhaka, Bangladesh.
Kerolos EisaMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Carolyn E BeckDivision of Paediatric Medicine, Department of Paediatrics, the Hospital for Sick Children, University of Toronto, Toronto, Canada.
Vicky R BreakeyDivision of Pediatric Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, Canada.
Kerstin de WitDepartment of Emergency Medicine, Queen's University, Kingston, Canada.
Stephen PorterDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Kathryn E WebertCanadian Blood Services, Ancaster, Canada.
Adam CukerDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Clare O'ConnorFaculty of Health Sciences, McMaster University, Hamilton, Canada.
Jennifer MacWhirter -DiRaimoPlatelet Disorder Support Association (PDSA), Cleveland, Ohio, USA.
Justin W YanLawson Health Research Institute, London Health Sciences Centre, Western University, London, Canada.
Charles ManskiNorthwestern University, Evanston, Illinois, USA.
John G KeltonMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Matthew KangJoseph Brant Hospital, Burlington, Canada.
Gail StrachanPlatelet Disorder Support Association (PDSA), Cleveland, Ohio, USA.
Ziauddin HassanSaskatchewan Health Authority, Saskatoon, Canada.
Barbara PruittPlatelet Disorder Support Association (PDSA), Cleveland, Ohio, USA.
Menaka PaiMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Rachael F GraceDana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA.
Dale PaynterPlatelet Disorder Support Association (PDSA), Cleveland, Ohio, USA.
Jay CharnessPlatelet Disorder Support Association (PDSA), Cleveland, Ohio, USA.
Nichola CooperDepartment of Inflammation and Immunity, Imperial College London, London, UK.
Steven FeinHeme on Call, Telemedicine-Based Hematology Practice, Miami, Florida, USA.
Arnav AgarwalDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Hasmik NazaryanMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Ishaq SiddiquiFaculty of Health Sciences, McMaster University, Hamilton, Canada.
Russell LeongFaculty of Health Sciences, McMaster University, Hamilton, Canada.
Sushmitha PallapothuDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Aaron WenMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Emily XuMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Bonnie LiuMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Amirmohammad ShafieeMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Preksha RathodMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Henry KwonDepartment of Surgery, Henry Ford Health, Detroit, Michigan, USA.
Jared DookieMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Dena ZeraatkarDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Rachel CoubanDepartment of Anesthesia, McMaster University, Hamilton, Canada.
Donald M ArnoldMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Canada.

Funding

Canadian Blood ServicesCIHREinstein Foundation Berlin
6 · The paper itself

Abstract

objectivesEvidence-based protocols for managing bleeding emergencies in patients with immune thrombocytopenia (ITP) are lacking. We conducted a systematic review of treatments for critical bleeding in patients with ITP.

methodsWe included all study designs and extracted data in aggregate or individually for patients who received one or more interventions and for whom any of the following outcomes were reported: platelet count response, bleeding, disability, or death.

resultsWe identified 49 eligible studies reporting 112 critical bleed patients with ITP, including 66 children (median age, 10 years), 36 adults (median age, 41.5 years), and 10 patients with unreported age. Patients received corticosteroids (n = 67), IVIG (n = 49), platelet transfusions (n = 41), TPO-RAs (n = 17), and splenectomy (n = 28) either alone or in combination. Studies reported 29 different treatment combinations, the 5 most common were corticosteroids, platelet transfusion and splenectomy (n = 13), corticosteroids and IVIG (n = 13), or splenectomy alone (n = 13); IVIG alone (n = 11); and corticosteroids, IVIG and TPO-RA (n = 8). Mortality among patients with critical bleeds in ITP was 30.6% for adults and 19.7% for children.

conclusionsThe effects of individual treatments on patient outcomes were uncertain due to very low-quality evidence. There is a need for a standardized approach to the treatment of ITP critical bleeds. SYSTEMATIC REVIEW REGISTRATION: CRD42020161206.

Indexed as

HemorrhagePurpura, Thrombocytopenic, IdiopathicAdrenal Cortex HormonesAdultChildCombined Modality TherapyDisease ManagementHumansImmunoglobulins, IntravenousPlatelet TransfusionSplenectomyTreatment OutcomeAdrenal Cortex HormonesImmunoglobulins, Intravenouscritical bleedingemergency managementimmune thrombocytopeniamajor bleedingthrombocytopenia

Identifiers

PMID39552264
PMCPMC11798764

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.