Keck School Faculty

Howard Liebman

Howard Liebman

Professor of Medicine, Don Feinstein Chair in Hematology
1441 Eastlake Ave. Health Sciences Campus Los Angeles

Durability of platelet response after switching to avatrombopag from eltrombopag or romiplostim in immune thrombocytopenia Res Pract Thromb Haemost. 2023 Mar; 7(3):100134. . View in PubMed

The unique diagnostic and management challenge of a patient with concomitant anti-interferon-gamma autoantibody associated immunodeficiency syndrome, IgG4-related disease, and treatment refractory, disseminated mycobacterium avium complex infection Allergy Asthma Clin Immunol. 2022 Sep 09; 18(1):82. . View in PubMed

Adults with immune thrombocytopenia who switched to avatrombopag following prior treatment with eltrombopag or romiplostim: A multicentre US study Br J Haematol. 2022 05; 197(3):359-366. . View in PubMed

SARS-CoV-2 vaccination and ITP in patients with de novo or preexisting ITP Blood. 2022 03 10; 139(10):1564-1574. . View in PubMed

Corticosteroid overuse in adults with immune thrombocytopenia: Cause for concern Res Pract Thromb Haemost. 2021 Aug; 5(6):e12592. . View in PubMed

Prediction and Prevention of Cancer-Associated Thromboembolism Oncologist. 2021 01; 26(1):e2-e7. . View in PubMed

Tapering thrombopoietin receptor agonists in primary immune thrombocytopenia: Expert consensus based on the RAND/UCLA modified Delphi panel method Res Pract Thromb Haemost. 2021 Jan; 5(1):69-80. . View in PubMed

Nattokinase atherothrombotic prevention study: A randomized controlled trial Clin Hemorheol Microcirc. 2021; 78(4):339-353. . View in PubMed

Understanding Immune Thrombocytopenia: Looking Out of the Box Front Med (Lausanne). 2021; 8:613192. . View in PubMed

Acute dilated cardiomyopathy in the setting of catastrophic antiphospholipid syndrome and thrombotic microangiopathy: A case series and review EJHaem. 2020 Jul; 1(1):44-50. . View in PubMed

Phase 2 study of efgartigimod, a novel FcRn antagonist, in adult patients with primary immune thrombocytopenia Am J Hematol. 2020 02; 95(2):178-187. . View in PubMed

Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Clinical Practice Guideline Update J Clin Oncol. 2020 02 10; 38(5):496-520. . View in PubMed

A Retrospective Study of the Combination of Rituximab, Cyclophosphamide and Dexamethasone for the Treatment of Relapsed/Refractory Warm Antibody Autoimmune Hemolytic Anemia Acta Haematol. 2020; 143(3):244-249. . View in PubMed

Are Tpo agonists an option for ITP in pregnancy? Blood. 2020 12 24; 136(26):2971-2972.. View in PubMed

A systematic literature review on the use of platelet transfusions in patients with thrombocytopenia Hematology. 2019 Dec; 24(1):679-719. . View in PubMed

Effect of thrombopoietin receptor agonists on markers of coagulation and P-selectin in patients with immune thrombocytopenia Platelets. 2019; 30(2):206-212. . View in PubMed

Targeting protein disulfide isomerase with the flavonoid isoquercetin to improve hypercoagulability in advanced cancer JCI Insight. 2019 02 21; 4(4). . View in PubMed

Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer N Engl J Med. 2019 02 21; 380(8):720-728. . View in PubMed

Ethnic and racial difference in Helicobacter pylori infection in patients with immune thrombocytopenia treated at a major urban medical center Platelets. 2019; 30(3):413-417. . View in PubMed

Cancer prognosis in patients with venous thromboembolism (VTE) and patients with clinical and laboratory biomarkers predictive of VTE risk Thromb Res. 2018 04; 164 Suppl 1:S19-S22. . View in PubMed

Predictors of Venous Thromboembolism and Early Mortality in Lung Cancer: Results from a Global Prospective Study (CANTARISK) Oncologist. 2018 02; 23(2):247-255. . View in PubMed

Clinical Predictors of Early Mortality in Colorectal Cancer Patients Undergoing Chemotherapy: Results From a Global Prospective Cohort Study JNCI Cancer Spectr. 2017 Sep; 1(1):pkx009. . View in PubMed

Autoimmune Hemolytic Anemia Med Clin North Am. 2017 Mar; 101(2):351-359. . View in PubMed

Rivaroxaban for Preventing Venous Thromboembolism in High-Risk Ambulatory Patients with Cancer: Rationale and Design of the CASSINI TrialRationale and Design of the CASSINI Trial. Thromb Haemost. 2017 11 01; 117(11):2135-2145. . View in PubMed

Incidental venous thromboembolic events in cancer patients: what we know in 2016 Thromb Res. 2016 Apr; 140 Suppl 1:S18-20. . View in PubMed

OC-14 - Baseline D-dimer levels are predictive of recurrent venous thromboembolism (VTE) at 6 months in cancer patients with VTE treated with tinzaparin Thromb Res. 2016 Apr; 140 Suppl 1:S174. . View in PubMed

Comparison of two dosing schedules for subcutaneous injections of low-dose anti-CD20 veltuzumab in relapsed immune thrombocytopenia Haematologica. 2016 11; 101(11):1327-1332. . View in PubMed

Immune modulation for autoimmune disorders: evolution of therapeutics Semin Hematol. 2016 04; 53 Suppl 1:S23-6. . View in PubMed

Risk of recurrent venous thromboembolism and major hemorrhage in cancer-associated incidental pulmonary embolism among treated and untreated patients: a pooled analysis of 926 patients J Thromb Haemost. 2016 Jan; 14(1):105-13. . View in PubMed

Life-threatening delayed hyperhemolytic transfusion reaction in a patient with sickle cell disease: effective treatment with eculizumab followed by rituximab Transfusion. 2015 Oct; 55(10):2398-403. . View in PubMed

Management of immune-mediated cytopenias in pregnancy Autoimmun Rev. 2015 Sep; 14(9):806-11. . View in PubMed

Management of cancer-associated disseminated intravascular coagulation: guidance from the SSC of the ISTH: reply J Thromb Haemost. 2015 Jul; 13(7):1352-3. . View in PubMed

Diagnosis and treatment of incidental venous thromboembolism in cancer patients: guidance from the SSC of the ISTH J Thromb Haemost. 2015 May; 13(5):880-3. . View in PubMed

Management of cancer-associated disseminated intravascular coagulation: guidance from the SSC of the ISTH J Thromb Haemost. 2015 Apr; 13(4):671-5. . View in PubMed

Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014 J Clin Oncol. 2015 Feb 20; 33(6):654-6. . View in PubMed

Approach to the management of incidental venous thromboembolic events in patients with cancer J Natl Compr Canc Netw. 2014 Nov; 12(11):1557-60. . View in PubMed

Thrombocytopenia in cancer patients Thromb Res. 2014 May; 133 Suppl 2:S63-9. . View in PubMed

Long-term safety and tolerability of romiplostim in patients with primary immune thrombocytopenia: a pooled analysis of 13 clinical trials Eur J Haematol. 2013 Nov; 91(5):423-36. . View in PubMed

Low-dose anti-CD20 veltuzumab given intravenously or subcutaneously is active in relapsed immune thrombocytopenia: a phase I study Br J Haematol. 2013 Sep; 162(5):693-701. . View in PubMed

Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update J Clin Oncol. 2013 Jun 10; 31(17):2189-204. . View in PubMed

Standardization of bleeding assessment in immune thrombocytopenia: report from the International Working Group Blood. 2013 Apr 04; 121(14):2596-606. . View in PubMed

Predictive model of venous thromboembolism in endometrial cancer Gynecol Oncol. 2013 Mar; 128(3):544-51. . View in PubMed

Prediction and prevention of thromboembolic events with enoxaparin in cancer patients with elevated tissue factor-bearing microparticles: a randomized-controlled phase II trial (the Microtec study) Br J Haematol. 2013 Feb; 160(4):530-7. . View in PubMed

Incidental venous thromboembolism in oncology patients J Thromb Haemost. 2012 Dec; 10(12):2602-4. . View in PubMed

Eculizumab therapy results in rapid and sustained decreases in markers of thrombin generation and inflammation in patients with PNH independent of its effects on hemolysis and microparticle formation Thromb Res. 2012 Sep; 130(3):361-8. . View in PubMed

A randomized phase II trial of apixaban for the prevention of thromboembolism in patients with metastatic cancer J Thromb Haemost. 2012 May; 10(5):807-14. . View in PubMed

Treating venous thromboembolism in patients with cancer Expert Rev Hematol. 2012 Apr; 5(2):201-9. . View in PubMed

Approach to the treatment, characterization and diagnosis of an acquired auto-antibody directed against factors prothrombin, factor X and factor IX: a case report and review of the literature Haemophilia. 2012 Jan; 18(1):102-7. . View in PubMed

Symptoms adversely impact survival among patients with cancer and unsuspected pulmonary embolism J Clin Oncol. 2011 Nov 01; 29(31):4208-9; author reply 4209-10. . View in PubMed

Unsuspected pulmonary emboli adversely impact survival in patients with cancer undergoing routine staging multi-row detector computed tomography scanning J Thromb Haemost. 2011 Feb; 9(2):305-11. . View in PubMed

Diagnosis and management of immune thrombocytopenia in the era of thrombopoietin mimetics Hematology Am Soc Hematol Educ Program. 2011; 2011:384-90. . View in PubMed

Clinical roundtable monographThe oncologist's role in management of venous thromboembolism. Clin Adv Hematol Oncol. 2011 Jan; 9(1):suppl 1-15. . View in PubMed

What do healthcare providers ask their patients with immune thrombocytopenia? Am J Hematol. 2010 Aug; 85(8):629-31.. View in PubMed

Increased microparticle tissue factor activity in cancer patients with Venous Thromboembolism Thromb Res. 2010 Jun; 125(6):511-2. . View in PubMed

The immune thrombocytopenia syndrome: a disorder of diverse pathogenesis and clinical presentation Hematol Oncol Clin North Am. 2009 Dec; 23(6):1155-61. . View in PubMed

Preface Hematol Oncol Clin North Am. 2009 Dec; 23(6):xi. . View in PubMed

Thyroid disease in patients with immune thrombocytopenia Hematol Oncol Clin North Am. 2009 Dec; 23(6):1251-60. . View in PubMed

Tumor-derived tissue factor-bearing microparticles are associated with venous thromboembolic events in malignancy Clin Cancer Res. 2009 Nov 15; 15(22):6830-40. . View in PubMed

The ITP syndrome: pathogenic and clinical diversity Blood. 2009 Jun 25; 113(26):6511-21. . View in PubMed

Anti-RhD immunoglobulin in the treatment of immune thrombocytopenia Biologics. 2009; 3:57-62. . View in PubMed

Pathobiology of secondary immune thrombocytopenia Semin Hematol. 2009 Jan; 46(1 Suppl 2):S2-14. . View in PubMed

Recognizing and treating secondary immune thrombocytopenic purpura associated with lymphoproliferative disorders Semin Hematol. 2009 Jan; 46(1 Suppl 2):S33-6. . View in PubMed

Managing cancer-related venous thromboembolic disease: low-molecular-weight heparins and beyond Expert Rev Hematol. 2008 Dec; 1(2):175-82. . View in PubMed

Subclinical haemostatic activation and current surgeon volume predict bleeding with open radical retropubic prostatectomy BJU Int. 2008 Nov; 102(9):1086-91. . View in PubMed

Heparin-platelet factor 4 antibodies are frequent after vascular surgery but are not a frequent cause of graft thrombosis or thrombocytopenia J Vasc Surg. 2008 Aug; 48(2):377-81. . View in PubMed

Heparin-induced thrombocytopenia: diagnosis and management Vascular. 2008 Mar-Apr; 16 Suppl 1:S71-6. . View in PubMed

Efficacy of romiplostim in patients with chronic immune thrombocytopenic purpura: a double-blind randomised controlled trial Lancet. 2008 Feb 02; 371(9610):395-403. . View in PubMed

Immune thrombocytopenia (ITP): an historical perspective Hematology Am Soc Hematol Educ Program. 2008; 205. . View in PubMed

Viral-associated immune thrombocytopenic purpura Hematology Am Soc Hematol Educ Program. 2008; 212-8. . View in PubMed

American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer J Clin Oncol. 2007 Dec 01; 25(34):5490-505. . View in PubMed

Other immune thrombocytopenias Semin Hematol. 2007 Oct; 44(4 Suppl 5):S24-34. . View in PubMed

The role of oral anticoagulants in tumor biology Semin Thromb Hemost. 2007 Oct; 33(7):695-8. . View in PubMed

Secondary immune thrombocytopenic purpura Curr Opin Hematol. 2007 Sep; 14(5):557-73. . View in PubMed

A closer look at intravascular hemolysis (IVH) following intravenous anti-D for immune thrombocytopenic purpura (ITP) Blood. 2007 Jun 15; 109(12):5527; author reply 5528. . View in PubMed

Unsuspected pulmonary emboli in cancer patients: clinical correlates and relevance J Clin Oncol. 2006 Oct 20; 24(30):4928-32. . View in PubMed

Progressive prothrombotic state in women with advancing HIV disease J Acquir Immune Defic Syndr. 2006 Aug 15; 42(5):572-7. . View in PubMed

Rituximab treatment for resistant antiphospholipid syndrome J Rheumatol. 2006 Feb; 33(2):355-7. . View in PubMed

Current perspectives on primary prophylaxis and patient risk factors for venous thromboembolism in the cancer patient Cancer Control. 2005 Sep; 12 Suppl 1:11-6. . View in PubMed

Hepatitis C virus-related thrombocytopenia: clinical and laboratory characteristics compared with chronic immune thrombocytopenic purpura Br J Haematol. 2005 Jun; 129(6):818-24. . View in PubMed

Meeting reportAcute promyelocytic leukemia-associated coagulopathy, 21 January 2004, London, United Kingdom. Leuk Res. 2005 Mar; 29(3):347-51. . View in PubMed

Subcutaneous lepirudin for heparin-induced thrombocytopenia and when other anticoagulants fail: illustrative cases Clin Adv Hematol Oncol. 2004 Jun; 2(6):382-4; discussion 384-6. . View in PubMed

Successful treatment of refractory pure red cell aplasia associated with lymphoproliferative disorders with the anti-CD52 monoclonal antibody alemtuzumab (Campath-1H) Br J Haematol. 2003 Oct; 123(2):278-81. . View in PubMed

Thrombosis in patients with paroxysmal noctural hemoglobinuria is associated with markedly elevated plasma levels of leukocyte-derived tissue factor Thromb Res. 2003; 111(4-5):235-8. . View in PubMed

Thromboembolic complications of cancer: epidemiology, pathogenesis, diagnosis, and treatment Am J Hematol. 2003 Jan; 72(1):43-52. . View in PubMed

Treatment of refractory antibody mediated autoimmune disorders with an anti-CD20 monoclonal antibody (rituximab) Ann Rheum Dis. 2002 Oct; 61(10):922-4. . View in PubMed

Treatment of hepatitis C related thrombocytopenia with interferon alpha Am J Hematol. 2001 Nov; 68(3):202-9. . View in PubMed

Acquired bleeding disorder in a patient with malignant lymphoma: antibody-mediated prothrombin deficiency Cancer. 2001 Feb 15; 91(4):636-41. . View in PubMed

Bone marrow response in treated patients with Gaucher disease: evaluation by T1-weighted magnetic resonance images and correlation with reduction in liver and spleen volume Skeletal Radiol. 2000 Oct; 29(10):563-71. . View in PubMed

Activated recombinant human coagulation factor VII (rFVIIa) therapy for abdominal bleeding in patients with inhibitory antibodies to factor VIII Am J Hematol. 2000 Mar; 63(3):109-13. . View in PubMed

Ticlopidine-induced aplastic anemia: development of chromosomal abnormalities and response to immunosuppressive therapy Am J Hematol. 2000 Mar; 63(3):141-4. . View in PubMed

Three Gaucher-disease-producing mutations in a patient with Gaucher disease: mechanism and diagnostic implications Acta Haematol. 2000; 104(2-3):103-5. . View in PubMed

Kinetics of factor IX activity differ from that of factor IX antigen in patients with haemophilia B receiving high-purity factor IX replacement Haemophilia. 1999 May; 5(3):174-80. . View in PubMed

The factor V Leiden mutation increases the risk of venous thrombosis in patients with inflammatory bowel disease Gastroenterology. 1998 Oct; 115(4):830-4. . View in PubMed

Tamoxifen-associated venous thrombosis and activated protein C resistance due to factor V Leiden Cancer. 1997 May 15; 79(10):2024-7. . View in PubMed

Evaluation of a tissue factor dependent factor V assay to detect factor V Leiden: demonstration of high sensitivity and specificity for a generally applicable assay for activated protein C resistance Br J Haematol. 1996 Dec; 95(3):550-3. . View in PubMed

Treatment of adult T-cell leukemia-lymphoma with a combination of interferon alfa and zidovudine N Engl J Med. 1995 Jun 29; 332(26):1744-8. . View in PubMed

Phase I/II clinical and pharmacokinetic evaluation of liposomal daunorubicin J Clin Oncol. 1995 Apr; 13(4):996-1003. . View in PubMed

Des-gamma-carboxy (abnormal) prothrombin and hepatocellular carcinoma: a critical review Hepatology. 1993 Oct; 18(4):990-7. . View in PubMed

pol mutations conferring zidovudine and didanosine resistance with different effects in vitro yield multiply resistant human immunodeficiency virus type 1 isolates in vivo Antimicrob Agents Chemother. 1993 Jul; 37(7):1480-7. . View in PubMed

The metal-dependent conformational changes in factor IX associated with phospholipid bindingStudies using antibodies against a synthetic peptide and chemical modification of factor IX. Eur J Biochem. 1993 Mar 01; 212(2):339-45. . View in PubMed

Didanosine in the treatment of AIDS and AIDS-related complex: a critical appraisal of the dose and frequency of administration Clin Infect Dis. 1993 Feb; 16 Suppl 1:S52-8. . View in PubMed

Effects of therapy with didanosine on hematologic parameters in patients with advanced human immunodeficiency virus disease Blood. 1992 Dec 15; 80(12):2969-76. . View in PubMed

Excessive fibrinolysis in amyloidosis associated with elevated plasma single-chain urokinase Am J Clin Pathol. 1992 Nov; 98(5):534-41. . View in PubMed

Impact of bioavailability on determination of the maximal tolerated dose of 2',3'-dideoxyinosine in phase I trials Antimicrob Agents Chemother. 1992 Jun; 36(6):1280-3. . View in PubMed

Population pharmacokinetic analysis of didanosine (2',3'-dideoxyinosine) plasma concentrations obtained in phase I clinical trials in patients with AIDS or AIDS-related complex J Clin Pharmacol. 1992 Mar; 32(3):242-7. . View in PubMed

A glycosaminoglycan inhibitor of thrombin: a new mechanism for abnormal hemostatic assays in cancer Am J Hematol. 1991 Sep; 38(1):24-9. . View in PubMed

Pulmonary Kaposi sarcoma in patients with AIDS: scintigraphic diagnosis with sequential thallium and gallium scanning Radiology. 1991 Aug; 180(2):409-12. . View in PubMed

Response to treatment with the leukocyte-derived immunomodulator IMREG-1 in immunocompromised patients with AIDS-related complexA multicenter, double-blind, placebo-controlled trial. Ann Intern Med. 1991 Jul 15; 115(2):84-91. . View in PubMed

Subcutaneous Kaposi's sarcomaThallium scan demonstration. Clin Nucl Med. 1990 Aug; 15(8):569-71. . View in PubMed

Treatment of AIDS and AIDS-related complex with 2',3'-dideoxyinosine given once daily Rev Infect Dis. 1990 Jul-Aug; 12 Suppl 5:S552-60. . View in PubMed

Once-daily administration of 2',3'-dideoxyinosine (ddI) in patients with the acquired immunodeficiency syndrome or AIDS-related complexResults of a Phase I trial. N Engl J Med. 1990 May 10; 322(19):1340-5. . View in PubMed

Isolation and characterization of a hepatoma-associated abnormal (des-gamma-carboxy)prothrombin Cancer Res. 1989 Dec 01; 49(23):6493-7. . View in PubMed

Increased T-cell colony formation in AIDS patients treated with zidovudine: a possible mechanism for increased lymphocyte number AIDS. 1989 Sep; 3(9):605-7. . View in PubMed

Factor IX San DimasSubstitution of glutamine for Arg-4 in the propeptide leads to incomplete gamma-carboxylation and altered phospholipid binding properties. J Biol Chem. 1989 Jul 05; 264(19):11401-6. . View in PubMed

AIDS-related Kaposi sarcoma: findings on thallium-201 scintigraphy AJR Am J Roentgenol. 1988 Dec; 151(6):1233-5. . View in PubMed

AIDS in intravenous drug users: issues related to enrollment in clinical trials J Acquir Immune Defic Syndr (1988). 1990; 3 Suppl 2:S45-50. . View in PubMed

The factor IX phospholipid-binding site is required for calcium-dependent activation of factor IX by factor XIa J Biol Chem. 1987 Jun 05; 262(16):7605-12. . View in PubMed

Molecular basis of hemophilia B: a defective enzyme due to an unprocessed propeptide is caused by a point mutation in the factor IX precursor Proc Natl Acad Sci U S A. 1986 Aug; 83(16):5803-7. . View in PubMed

Immunoaffinity purification of factor IX (Christmas factor) by using conformation-specific antibodies directed against the factor IX-metal complex Proc Natl Acad Sci U S A. 1985 Jun; 82(11):3879-83. . View in PubMed

Comparison of the native prothrombin antigen and the prothrombin time for monitoring oral anticoagulant therapy Blood. 1984 Aug; 64(2):445-51. . View in PubMed

Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma N Engl J Med. 1984 May 31; 310(22):1427-31. . View in PubMed

Increased fibrinolysis and amyloidosis Arch Intern Med. 1983 Apr; 143(4):678-82. . View in PubMed

Severe depression of antithrombin III associated with disseminated intravascular coagulation in women with fatty liver of pregnancy Ann Intern Med. 1983 Mar; 98(3):330-3. . View in PubMed

Antithrombin III and anti-activated factor X activity in patients with acute promyelocytic leukemia and disseminated intravascular coagulation treated with heparin Cancer. 1983 Feb 15; 51(4):681-5. . View in PubMed

Successful therapy of convoluted T-lymphoblastic lymphoma in the adult Blood. 1983 Jan; 61(1):92-8. . View in PubMed

Antithrombin III and anti-activated factor X activity in patients with acute promyelocytic leukemia and disseminated intravascular coagulation treated with heparin Cancer. 1982 Nov 15; 50(10):2106-10. . View in PubMed

Depression of functional and antigenic plasma antithrombin III (AT-III) due to therapy with L-asparaginase Cancer. 1982 Aug 01; 50(3):451-6. . View in PubMed

Hepatic vitamin K-dependent carboxylation of blood-clotting proteins Hepatology. 1982 Jul-Aug; 2(4):488-94. . View in PubMed

Dr. Howard Liebman, Professor of Medicine and Pathology is the author or co-author of over 170 peer reviewed publications, review articles and chapters. He has presented over two hundred lectures across the United States, South America, Europe. Korea and Japan. He has served as the former Chair of the Massachusetts Governor's Task Force subcommittee on experimental therapies and clinical trials for AIDS. He is a medical advisor for the Platelet Disorder Support Association and a member of the Cancer and Thrombosis Guidelines Committee of the American Society of Clinical Oncology. He has served on several grant review committees for the National Institute of Health. He presently holds the Donald I Feinstein Endowed Chair of Hematology.

In addition to his academic responsibilities, Dr. Liebman is an attending staff member of the LAC+USC Medical Center, the USC/Norris Comprehensive Cancer Center and the Keck Hospital of USC. Dr. Liebman also is on the forefront of research in thrombotic and hemorrhagic disorders. His lab is currently studying the genetic risk factors responsible for thrombotic diseases including venous thrombosis, pulmonary embolism, and arterial thrombosis. Dr. Liebman is also internationally known for his work in the relationships between venous thrombotic disease and underlying malignancy. He has been and is the principal investigator on several clinical trials in the management of immune thrombocytopenia (ITP). His research group has made important discoveries on the role of infectious agents in the development of immune thrombocytopenia and secondary ITP.
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