ASH 2019 guidelines for immune thrombocytopenia: “Old wine in a new bottle with added spices”

The management of immune thrombocytopenic purpura (ITP) in children show great variation among physicians and centers. American Society of Hematology (ASH) has recently (2019) come up with updated guidance on the management of ITP in children and adults. There is no major change compared to ASH 2011 guidance, except for thrombopoietic receptor agonists (TPO-RAs) finding significant space in the ITP management armamentarium in the latest guidelines and steroids being recommended as a first line therapy. The ASH 2019 guideline is discussed in this review with realworld case examples. ASH 2019 guidelines help physicians manage patients with ITP in a rational way. The limitations of ASH guidelines, especially in Indian settings, are highlighted.