Oncology Today with Dr Neil Love Immune Thrombocytopenia — Microlearning Activity 3 with Dr Hanny Al-Samkari: ASH 2025 Review
Mar 21, 2026
Dr Hanny Al-Samkari, a hematologist and clinical investigator at Massachusetts General Hospital, discusses ASH 2025 advances in immune thrombocytopenia. He covers combining TPO receptor agonists with B-cell therapies, emergency rescue strategies including splenectomy, choices to avoid thrombocytosis, and practical concerns like iron deficiency and steroid strategies.
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Episode notes
Move Quickly To Steroid-Sparing Second Line
- Use a second-line nonsteroidal therapy after first-line steroids to spare steroid exposure.
- Hanny Al-Samkari recommends starting a TPO-RA or agents like rilzabrutinib/fostamatinib once steroids/IVIG responses are inadequate.
Combine BAFF-R Blockade With TPO-RA For Durability
- Consider disease-modifying combinations for relapsed ITP when aiming for durable responses.
- Al-Samkari suggests combining a BAFF-R antagonist (yonalimumab) with a TPO-RA (eltrombopag) if available to attempt treatment-free remissions.
Emergency Splenectomy Saved A Young Patient
- Emergency splenectomy can rescue life-threatening bleeds when multiple rapid therapies fail.
- Al-Samkari described a 30s patient with platelet count of 1, GI and CNS bleeds who ultimately responded after emergency splenectomy.