Prospective Evaluation of the First Option, Second-Line Therapy in Childhood Chronic Immune Thrombocytopenia: Splenectomy or Immunomodulation

This French national cohort study of 137 pediatric chronic ITP patients compared splenectomy versus immunomodulatory therapies as first second-line treatment. Splenectomy demonstrated superior 24-month event-free survival (85%) compared to rituximab (60%), azathioprine (46%), and hydroxychloroquine (37%), with age >10 years at surgery showing improved outcomes.