Featured Publications
Definition of a critical bleed in patients with immune thrombocytopenia: Communication from the ISTH SSC Subcommittee on Platelet Immunology
Sirotich E, Guyatt G, Gabe C, Ye Z, Beck C, Breakey V, Cooper N, Cuker A, Charness J, de Wit K, DiRaimo J, Fein S, Grace R, Hassan Z, Jamula E, Kang M, Manski C, O'Connor C, Pai M, Paynter D, Porter S, Pruitt B, Strachan G, Webert K, Yan J, Kelton J, Bakchoul T, Arnold D. Definition of a critical bleed in patients with immune thrombocytopenia: Communication from the ISTH SSC Subcommittee on Platelet Immunology. Journal Of Thrombosis And Haemostasis 2021, 19: 2082-2088. PMID: 34327824, DOI: 10.1111/jth.15368.Peer-Reviewed Original ResearchConceptsImmune thrombocytopeniaSevere thrombocytopeniaGuideline panelCritical anatomical sitesLow platelet countISTH SSC SubcommitteeBleeding eventsMajor bleedsOngoing bleedPlatelet immunologyCompartment syndromeHemodynamic instabilityRespiratory compromisePhysiologic riskPlatelet countAutoimmune diseasesUrgent treatmentPatient representativesAnatomical sitesThrombocytopeniaUpcoming guidelinesPatientsBleedStandardized definitionsClinical expertsPerformance characteristics of platelet autoantibody testing for the diagnosis of immune thrombocytopenia using strict clinical criteria
Gabe C, Sirotich E, Li N, Ivetic N, Nazy I, Smith J, Kelton J, Arnold D. Performance characteristics of platelet autoantibody testing for the diagnosis of immune thrombocytopenia using strict clinical criteria. British Journal Of Haematology 2021, 194: 439-443. PMID: 34109621, DOI: 10.1111/bjh.17566.Peer-Reviewed Original ResearchConceptsPlatelet autoantibody testingImmune thrombocytopeniaAutoantibody testingPlatelet autoantibodiesITP patientsDiagnosis of ITPCertain patient subsetsAnti-glycoprotein IIb/IIIaStrict clinical criteriaHigh pretest probabilityAntigen capture assayIIb/IIIaPatient subsetsClinical criteriaPretest probabilityTreatment responsePatientsHigher optical density valuesOptical density valuesThrombocytopeniaAutoantibodiesCapture assayDiagnosisSpecificityTesting
2024
Treatment of Critical Bleeds in Patients With Immune Thrombocytopenia: A Systematic Review
Chowdhury S, Sirotich E, Guyatt G, Gill D, Modi D, Venier L, Mahamad S, Chowdhury M, Eisa K, Beck C, Breakey V, de Wit K, Porter S, Webert K, Cuker A, O'Connor C, ‐DiRaimo J, Yan J, Manski C, Kelton J, Kang M, Strachan G, Hassan Z, Pruitt B, Pai M, Grace R, Paynter D, Charness J, Cooper N, Fein S, Agarwal A, Nazaryan H, Siddiqui I, Leong R, Pallapothu S, Wen A, Xu E, Liu B, Shafiee A, Rathod P, Kwon H, Dookie J, Zeraatkar D, Thabane L, Couban R, Arnold D. Treatment of Critical Bleeds in Patients With Immune Thrombocytopenia: A Systematic Review. European Journal Of Haematology 2024 PMID: 39552264, DOI: 10.1111/ejh.14351.Peer-Reviewed Original ResearchImmune thrombocytopeniaCritical bleedingTPO-RAsPlatelet transfusionsCritically bleeding patientsPlatelet count responseSystematic reviewReview of treatmentBleeding patientsIVIGEvidence-based protocolsBleedingBleeding emergenciesCorticosteroidsSystematic review of treatmentsPatientsSplenectomyPatient outcomesIndividualized treatmentThrombocytopeniaPlateletTransfusionEffects of individual treatmentsTreatmentStudy designTreatment of critical bleeding events in patients with immune thrombocytopenia: a protocol for a systematic review and meta-analysis
Sirotich E, Nazaryan H, Chowdhury S, Guyatt G, Agarwal A, Leong R, Wen A, Xu E, Liu B, Pallapothu S, Rathod P, Kwon H, Dookie J, Shafiee A, Charness J, DiRaimo J, Paynter D, Pruitt B, Strachan G, Couban R, Ye Z, Arnold D. Treatment of critical bleeding events in patients with immune thrombocytopenia: a protocol for a systematic review and meta-analysis. Systematic Reviews 2024, 13: 21. PMID: 38184622, PMCID: PMC10770981, DOI: 10.1186/s13643-023-02436-6.Peer-Reviewed Original ResearchConceptsCritical bleedingSystematic reviewEvidence-based treatment protocolsBleeding-related mortalityCochrane Central RegisterEvidence-based recommendationsFull-text screeningBleeding eventsImmune thrombocytopeniaRecommendations AssessmentCentral RegisterControlled TrialsPrimary outcomeSevere thrombocytopeniaPlatelet countEligible studiesPatient outcomesEmergency settingOvid MEDLINEObservational studyTreatment protocolHigh riskMedical emergencyElectronic databasesMethodsLiterature search
2023
Treatment of Critical Bleeding Events in Patients with Immune Thrombocytopenia: A Systematic Review
Sirotich E, Chowdhury S, Guyatt G, Gill D, Modi D, Venier L, Eisa K, Beck C, Breakey V, de Wit K, Porter S, Webert K, Cuker A, O'Connor C, DiRaimo J, Yan J, Manski C, Kelton J, Kang M, Strachan G, Hassan Z, Pruitt B, Pai M, Grace R, Paynter D, Charness J, Cooper N, Fein S, Nazaryan H, Agarwal A, Siddiqui I, Leong R, Pallapothu S, Wen A, Xu E, Liu B, Rathod P, Kwon H, Dookie J, Shafiee A, Couban R, Arnold D. Treatment of Critical Bleeding Events in Patients with Immune Thrombocytopenia: A Systematic Review. Blood 2023, 142: 7239. DOI: 10.1182/blood-2023-179448.Peer-Reviewed Original ResearchPlatelet count responseTPO-RAsImmune thrombocytopeniaPlatelet transfusionsCritical bleedingBleed resolutionTreated with platelet transfusionsPatients treated with splenectomyControlled trialsCritical bleeding eventsManagement of critical bleedingTPO receptor agonistsCochrane Central Register of Controlled TrialsCentral Register of Controlled TrialsRegister of Controlled TrialsSystematic reviewTreatment of critical bleedingCochrane Central RegisterReview of treatmentEvidence-based treatment protocolsClinical practice guidelinesRandomized controlled trialsCount responseIntraperitoneal bleedingOcular bleeding
2020
Management of major bleeds in patients with immune thrombocytopenia
Mithoowani S, Cervi A, Shah N, Ejaz R, Sirotich E, Barty R, Li N, Nazy I, Arnold D. Management of major bleeds in patients with immune thrombocytopenia. Journal Of Thrombosis And Haemostasis 2020, 18: 1783-1790. PMID: 32219982, DOI: 10.1111/jth.14809.Peer-Reviewed Original ResearchConceptsMajor bleedsImmune thrombocytopeniaEmergency departmentITP patientsEvidence-based treatment strategiesIntravenous immune globulinRetrospective cohort studyPermanent neurological disabilityITP therapyMajor bleedingRecurrent bleedsHemodynamic instabilityMinor bleedingCohort studyED visitsGross hematuriaImmune globulinAcute treatmentNeurological disabilityArterial thrombosisPlatelet transfusionsSevere thrombocytopeniaSignificant morbidityMale sexRisk factors
2019
Second-Line Therapy for Immune Thrombocytopenia: Real-World Experience
Nazaryan H, Liu Y, Sirotich E, Duncan J, Arnold D. Second-Line Therapy for Immune Thrombocytopenia: Real-World Experience. Blood 2019, 134: 2120. DOI: 10.1182/blood-2019-128336.Peer-Reviewed Original ResearchSecond-line therapySecond-line treatmentImmune thrombocytopeniaTreatment start dateTPO-RAsEarly second-line therapyTreatment sequenceCommon treatment sequencesProspective longitudinal registryTherapy-associated toxicitiesRetrospective cohort studyFirst-line therapyProportion of patientsSecondary immune thrombocytopeniaSequence of therapyThrombopoietin receptor agonistsReal-world experienceCanadian academic centersLarge Canadian academic centerBristol-Myers SquibbSequence of treatmentImmunosuppressant medicationsOrder of treatmentTPO-RACohort study