Objective    To retrieve the best evidence-based treatment modality for a patient with chronic immune thrombocytopenic purpura (ITP).     Methods    According to the principles of patient intervention comparison outcome (PICO)

studies on chronic ITP were retrieved from Cochrane Library

MEDLINE

Embase

CBMdisc

CNKI

VIP and Wanfang databases. All studies were critically assessed and analyzed by meta-analysis using the RevMan 5.0 software. A treatment modality for chronic ITP was established according to the preference of the patient.     Results    Eighteen prospective studies

2 systematic reviews

and 1 study on clinical guidelines for the treatment of chronic ITP were included in the study. The evidence indicated that no random control study on comparison between the effects of rituximab and splenectomy was found in patients with chronic ITP. Rituximab was effective against chronic ITP in approximately 60% of patients. The incidence of its adverse events was lower than that of splenectomy. Meta-analysis showed that splenectomy did not influence the curative effect of rituximab on chronic ITP (P0.05).     Conclusion     Rituximab can be used in treatment of chronic ITP before splenectomy and is the best choice of treatment for those at a high risk for splenectomy.