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英国原发性免疫性血小板减少症患者血栓形成风险的恰当管理:一项改良德尔菲共识

Appropriate Management of Thrombotic Risk in Patients With Primary Immune Thrombocytopenia in the UK: A Modified Delphi Consensus.

作者信息

Bradbury Charlotte, Thachil Jecko, McWilliams Matthew, Lester Will A

机构信息

Department of Haematology University of Bristol Bristol UK.

Manchester Royal Infirmary Manchester UK.

出版信息

EJHaem. 2025 Sep 3;6(5):e70134. doi: 10.1002/jha2.70134. eCollection 2025 Oct.

Abstract

INTRODUCTION

Immune thrombocytopenia (ITP) is characterised by a low platelet count and increased risk of bleeding. Recent research has also proposed that having ITP increases thrombosis risk. Moreover, certain ITP treatments have been associated with an increased risk of thrombosis. This Delphi study aims to assess haematologist opinion regarding aspects of optimise thrombotic risk management in primary ITP in the UK.

METHODS

The methodology employed a modified Delphi process with two rounds of evaluation from a panel of experts. A literature review on the topic of primary ITP generated input to a steering group of three experts from the UK attended a virtual meeting in May 2024. During this meeting, and guided by an independent facilitator, the group identified five main domains. From these, 42 statements were agreed and developed into an online survey for testing with a wider panel of peers.

RESULTS

Overall, 33 statements achieved consensus agreement, and one statement did not achieve consensus. Eight scenario statements were included to identify preferable treatment options among healthcare professionals.

CONCLUSION

Based on the agreement levels achieved, the steering group formulated a set of recommendations to optimise the management of thrombotic risk in patients with primary ITP in the UK.

TRIAL REGISTRATION

The authors have confirmed clinical trial registration is not needed for this submission.

摘要

引言

免疫性血小板减少症(ITP)的特征是血小板计数低和出血风险增加。最近的研究还提出,患有ITP会增加血栓形成风险。此外,某些ITP治疗与血栓形成风险增加有关。这项德尔菲研究旨在评估英国血液科医生对原发性ITP中优化血栓形成风险管理方面的意见。

方法

该方法采用了改良的德尔菲流程,由专家小组进行两轮评估。对原发性ITP主题的文献综述为来自英国的三位专家组成的指导小组提供了资料,他们于2024年5月参加了一次虚拟会议。在这次会议上,在一名独立主持人的指导下,该小组确定了五个主要领域。据此,商定了42条陈述,并将其发展成一项在线调查,以供更广泛的同行小组进行测试。

结果

总体而言,33条陈述达成了共识,1条陈述未达成共识。纳入了8条情景陈述,以确定医疗保健专业人员中更可取的治疗方案。

结论

根据达成的一致程度,指导小组制定了一套建议,以优化英国原发性ITP患者血栓形成风险的管理。

试验注册

作者已确认本提交内容无需进行临床试验注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/991f/12406081/6e136c567df6/JHA2-6-e70134-g001.jpg

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