ReviewFrontiers in immunology2026
Case Report: Hematopoietic stem cell transplantation for refractory chronic immune thrombocytopenia in a child.
Review in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder characterized by immune-mediated platelet destruction and impaired platelet production. While pediatric ITP is often self-limited or responsive to first-line therapies, such as corticosteroids and intravenous immunoglobulin (IVIG), a small subset develop refractory chronic disease. Hematopoietic stem cell transplantation (HSCT) has been explored as a potential immune-reconstituting rescue intervention for highly selected patients with multiple treatment failures, prolonged severe thrombocytopenia, and persistent bleeding risk. Here, we report a case of a 6-year-old child with refractory chronic ITP who had severe thrombocytopenia and recurrent life-threatening bleeding despite 11 first-line, second-line, and salvage treatment regimens and ultimately underwent 10/10 HLA-matched unrelated donor allogeneic HSCT (allo-HSCT). After transplantation, the patient experienced delayed platelet recovery, acute graft-versus-host disease (aGvHD), viral reactivation and transient transplant-associated thrombotic microangiopathy (TA-TMA). After repeated treatment adjustments guided by close real-time clinical monitoring, he eventually achieved stable trilineage engraftment and has remained in complete remission (platelet count ≥100×10
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