Episode 1: Part 1 Diagnostic Issues in ITP

About the Moderators

James B. Bussel MD

  • Weill Cornell Medicine
  • New York, USA

Nichola Cooper, MD

  • Imperial College and Hammersmith Hospital
  • London, UK

Brief Bios:

James B. Bussel, MD

Mention the words “immune thrombocytopenia” and the name Jim Bussel comes immediately to mind. Dr. Bussel, Emeritus Professor of Pediatrics, Medicine and Obstetrics and Gynecology at Weill Cornell Medicine in New York City, has focused his clinical and research interests throughout his distinguished career primarily on ITP and fetal and neonatal alloimmune thrombocytopenia (FNAIT). A graduate of Yale University and Columbia College of Physicians and Surgeons, Dr. Bussel completed a residency in pediatrics at Cincinnati Children’s Hospital and a fellowship in Pediatric Hematology-Oncology at Weill Cornell and Memorial Sloan Kettering Cancer Center. He has spent his professional life at Weill Cornell Medicine, has published more than 400 manuscripts largely on ITP, and has been a principal investigator on numerous clinical trials on ITP in children and adults. Dr. Bussel participated in the development of the first ASH ITP guideline and in the Consensus manuscript. In 2012 he was awarded the King Faisal Prize for Medicine, the so-called Arab Nobel prize.


Nichola Cooper, MD

On the other side of the Atlantic, Dr. Nichola Cooper, consultant hematologist at Hammersmith Hospital and Clinical Senior Lecturer at Imperial College London in the United Kingdom, has been focusing her research on understanding the molecular basis of autoimmune conditions in hematology, particularly immune thrombocytopenia (ITP). Dr. Cooper trained at Cambridge University and Barts and the London School of Medicine and Dentistry. After completing her hematology training at University College Hospital, she gained research experience at Weill Cornell Medical College in New York, where she worked with Dr. Bussel. She subsequently returned to further her research at the Institute of Child Health, University College London and sees both children and adults with ITP. Dr. Cooper is widely accepted as the leader in ITP in Europe and is conducting a number of clinical studies of diagnosis, biology and pathophysiology, and treatment. She lectures worldwide and is on both the Consensus document and the current ASH guideline committee. She has a recent publication in Nature describing a novel gene leading to autoimmunity of an unusual type. Dr. Cooper’s take-away: "ITP is about more than bruising and risk of bleeding.”


The collaboration between Drs. Cooper and Bussel continues to this day, including work on one of the largest ITP patient surveys conducted to date. The survey demonstrated a high impact of the disease on patients’ emotional well-being and other aspects of day-to-day functioning.

Faculty Disclosures

James Bussel: Speaker: Novartis; Consultant: Novartis, Amgen, Dova, Rigel, Momenta, UCB, Argenx, RallyBio, and Regeneron; Honoraria: Up to Date

Nichola Cooper: Honoraria: Novartis, Amgen, Rigel, UCB; Principal/chief investigator: Rigel, Amgen UCB, Principa

References

  1. Al-Samkari H, Kuter DJ. Thrombopoietin level predicts response to treatment with eltrombopag and romiplostim in immune thrombocytopenia. Am J Hematol 2018;93:1501-8.
  2. Arnold DM, Nazy I, Clare R, et al. Misdiagnosis of primary immune thrombocytopenia and frequency of bleeding: lessons from the McMaster ITP Registry. Br J Haematol. 2018;181(2):234-241.
  3. Bussel J, Arnold DM, Grossbard E, Mayer J, Trelinski J, Homenda W, et al. Fostamatinib for the treatment of adult persistent and chronic immune thrombocytopenia: Results of two phase 3, randomized, placebo-controlled trials. Am J Hematol 2018;93:921-930.
  4. Chaturvedi S, Arnold DM, McCrae KR. Splenectomy for immune thrombocytopenia: down but not out. Blood 2018;131:1172-1182.
  5. Cooper N. State of the art – how I manage immune thrombocytopenia. Br J Haematol 2017;177:39-54.
  6. Cooper N, Stasi R, Cunningham-Rundles S, Feuerstein MA, Leonard JP, Amadori S, Bussel JB. The efficacy and safety of B-cell depletion with anti-CD20 monoclonal antibody in adults with chronic immune thrombocytopenic purpura. Br J Haematol 2004;125:232-9.
  7. Falet H, Hoffmeister KM, Grozovsky R. Desialylated platelets: A missing link in hepatic thrombopoietin regulation. The Haematologist 2015;12(3):6.
  8. Guidry JA, George JN, Vesely SK, Kennison SM, Terrell DR. Corticosteroid side-effects and risk for bleeding in immune thrombocytopenic purpura: patient and hematologist perspectives. Eur J Haematol 2009; 83:175-82.
  9. Newland A, Godeau B, Priego V, Biallard JF, Lopez Fernandez MF, Orejudos A, et al. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol 2016;172:262-73.
  10. Rodeghiero F. A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP. Br J Haematol 2018;181:183-195.
  11. Stasi R, Amadori S, Osborn J, Newland AC, Provan D. Long-term outcome of otherwise healthy individuals with incidentally discovered borderline thrombocytopenia. PLoS Med 2006;3:e24.
  12. Webster ML, Sayeh E, Crow M, Chen P, Nieswandt B, Freedman J, Ni H. Relative efficacy of intravenous immunoglobulin G in ameliorating thrombocytopenia induced by antiplatelet GPIIbIIIa versus GPIbalpha antibodies. Blood 2006;108:943-6.