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The 2025 McMaster Immune Thrombocytopenia (ITP) Summit: insights from autoimmune hemolytic anemia

Year: 2026

Type: review

Abstract: The third McMaster Immune Thrombocytopenia (ITP) Summit was held on 7 November 2025 and focused on comparing the mechanisms, diagnoses, and treatments with warm autoimmune hemolytic anemia (wAIHA) to inform our understanding of ITP. Topics compared the clinical presentation and laboratory diagnosis, pathophysiology, and current and emerging therapies. Key messages were that ITP and wAIHA share similar immune mechanisms, including pathogenic autoantibodies against platelets or red blood cells (RBCs), immune-mediated cellular pathways leading to platelet or RBC clearance, complement activation, and broader immune dysregulation. However, there are several distinct differences: ITP is more common than wAIHA; the spleen is enlarged in wAIHA but not primary ITP; the autoantibody in ITP is not readily detectable, whereas an RBC autoantibody can be found in the vast majority of patients with wAIHA; and anti-CD20 therapy appears to be more effective in wAIHA compared with ITP. Emerging therapies targeting B-cell signaling, plasma cells, neonatal Fc receptor, complement, and other immune pathways will expand treatment options and clarify disease biology. The summit also highlighted the patient experience of living with wAIHA and ITP and the importance of incorporating patient experience into therapeutic decision-making. Future priorities include improving diagnostic algorithms for ITP, identifying biomarkers of ITP disease activity and treatment response, and developing individualized treatment strategies based on the underlying disease mechanism.

Source: Blood Vessels Thrombosis & Hemostasis

DOI: 10.1016/j.bvth.2026.100215