The primary goals of our research are to better characterize and treat the thrombocytopenias.
The diseases encompassed include: Immune Thrombocytopenic Purpura (ITP), HIV-related Thrombocytopenia (HIV-TP), Immune Thrombocytopenias in Pregnancy: both ITP and Alloimmune Thrombocytopenia (AIT), and the congenital Amegakaryocytic Thrombocytopenias (AMT).
The specific aims are to better understand the pathophysiology so that management can be improved by:
1) determination of patient risk so that intensity of therapy can be individualized;
2) identification of factors indicative of critical disease mechanisms to optimize selection of treatment in individual patients; and
3) development of new therapies to increase the therapeutic index, increase the patient's quality of life, and reduce cost (if possible).
ITP:
1. explore different treatments and disease markers for avoidance of splenectomy
2. explore different treatments and disease markers in patients refractory to splenectomy
3. explore the role of platelet production generally and how best to measure it
HIV-ITP:
1. explore the significance of viral load and changes in viral load in regard to thrombocytopenia analyze aspects of platelet production and of platelet destruction.
ITP in Pregnancy:
Study different measurements of anti-platelet antibodies:
1. to distinguish ITP from gestational thrombocytopenia
2. to predict fetal and neonatal thrombocytopenia
3. to better define the natural history of ITP in pregnancy
Alloimmune Thrombocytopenia of Pregnancy:
1. Explore the natural history of fetal thrombocytopenia
2. Use serology, previous sibling history, fetal blood sampling, and other testing to assess risk to the fetus of intracranial hemorrhage
3. Continue to design treatment strategies to increase the fetal platelet count in order to prevent intracranial hemorrhage
4. Study longterm medical and developmental outcome
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