Original Article

International Journal of Hematology

, Volume 99, Issue 4, pp 413-417

First online:

Eltrombopag therapy in newly diagnosed steroid non-responsive ITP patients

  • Anil Kumar TripathiAffiliated withDepartment of Clinical Hematology and Medical Oncology, King George’s Medical University
  • , Ayush ShuklaAffiliated withDepartment of Clinical Hematology and Medical Oncology, King George’s Medical University Email author 
  • , Sanjay MishraAffiliated withDepartment of Clinical Hematology and Medical Oncology, King George’s Medical University
  • , Yogendra Singh YadavAffiliated withDepartment of Clinical Hematology and Medical Oncology, King George’s Medical University
  • , Deependra Kumar YadavAffiliated withDepartment of Clinical Hematology and Medical Oncology, King George’s Medical University

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Abstract

Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterised by isolated thrombocytopenia (peripheral blood platelet count <100 × 109/L) in the absence of other causes or disorders that may be associated with thrombocytopenia. The upfront treatment in newly diagnosed ITP patients is steroids; however, about one-third patients do not respond, and require other treatment, including IVIg, anti-D, or splenectomy. Previous studies have shown decreased platelet production in some ITP patients, aside from the evidence of enhanced platelet destruction. Thrombopoietin receptor agonists (TPO-RA), such as eltrombopag have been shown to provide good response in steroid non-responsive chronic ITP patients. We have studied response to eltrombopag in 25 newly diagnosed steroid non-responsive ITP patients; 80 % patients showed response at the end of 1 month, and 76 % sustained response at the end of 3 months. The platelet count rose from a mean value of 17.5 ± 3.6–152.5 ± 107.9 × 109/L at the end of 1 month. Our results suggest a possible role of eltrombopag in newly diagnosed steroid non-responsive ITP patients. However, our study is limited in that it is a single-centre study, with a small sample size, and lacks a long-term safety profile. Our findings highlight the potential value of a larger prospective study on the upfront use of TPO-RA in patients of ITP.

Keywords

Primary ITP ITP TPO-RA Eltrombopag