Platelet count remains the most objective measure of ITP severity and the efficacy of ITP treatment. However, with the exception of severe cases (counts below 10,000/µL), platelet counts may not tell the whole story. Most patients will do well if their platelet count remains over 30,000/µL. At that level, there is a minimal risk of bleeding and no demonstrated higher risk of mortality than in the general population.¹

These questions merit further investigation:

• How does ITP affect the ability of an adult patient to be productive and earn a living?²
• How much does ITP restrict a patient’s physical activity? Is such restriction prudent or an overreaction (by an adult patient or the parents of a child with ITP)?²
• Is fatigue an issue for the patient?³
• Are other lifestyle aspects affected by concerns about severe bleeding?²
• In general, does the patient have a fear of severe bleeding that is proportionate to the risk?²
• Is the patient’s body image affected by the signs of ITP? Or by the effects of treatment? If so, how severe is the psychological effect for a child or an adult with ITP?²

As treatment options evolve and improve, therapeutic guidelines should be updated so that both physician and patient have a reasonable set of expectations about lifestyle, treatment, and the long-term approach to ITP.