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Eltrombopag therapy in newly diagnosed steroid non-responsive ITP patients

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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.

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Authors and Affiliations

  1. Department of Clinical Hematology and Medical Oncology, King George’s Medical University, Lucknow, 226003, U.P., India

    Anil Kumar Tripathi, Ayush Shukla, Sanjay Mishra, Yogendra Singh Yadav & Deependra Kumar Yadav

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  1. Anil Kumar Tripathi
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  2. Ayush Shukla
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  3. Sanjay Mishra
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  4. Yogendra Singh Yadav
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  5. Deependra Kumar Yadav
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Correspondence to Ayush Shukla.

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Tripathi, A.K., Shukla, A., Mishra, S. et al. Eltrombopag therapy in newly diagnosed steroid non-responsive ITP patients. Int J Hematol 99, 413–417 (2014). https://doi.org/10.1007/s12185-014-1533-y

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  • DOI: https://doi.org/10.1007/s12185-014-1533-y

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