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Romiplostim for secondary thrombocytopenia following allogeneic stem cell transplantation in children

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Abstract

The outcome of romiplostim for secondary failure of platelet recovery (SFPR) was investigated in children who had undergone hematopoietic stem cell transplantation (HSCT). Seven transfusion-dependent pediatric patients (median age 11 years), with platelet counts below 10 × 109/L, received four weekly doses of subcutaneous romiplostim to treat SFPR developed after HSCT. All patients, except one (patient 4), became platelet transfusion-independent in the second week from the beginning of treatment and no patient needed to discontinue drug treatment because of adverse events. Romiplostim could represent a beneficial first-line treatment, but further studies are required.

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References

  1. Imbach P, Crowther M. Thrombopoietin-receptor agonists for primary immune thrombocytopenia. N Engl J Med. 2011;365:734–41.

    Article  CAS  PubMed  Google Scholar 

  2. Poon LM, Di Stasi A, Popat U, Champlin RE, Ciurea SO. Romiplostim for delayed platelet recovery and secondary thrombocytopenia following allogeneic stem cell transplantation. Am J Blood Res. 2013;3(3):260–4.

    PubMed Central  CAS  PubMed  Google Scholar 

  3. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, et al. 1994 Consensus conference on acute GVHD grading. Bone Marrow Transplant. 1995;15:825–8.

    CAS  PubMed  Google Scholar 

  4. Beck JC, Burke MJ, Tolar J. Response of refractory immune thrombocytopenia after bone marrow transplantation to romiplostim. Pediatr Blood Cancer. 2010;54:490–1.

    Article  PubMed  Google Scholar 

  5. Bat T, Seth M, Steinberg SM, Childs R, Calvo KR, Barrett AJ, et al. Active thrombopoiesis associated with worse severity and activity of chronic graft-versus-host disease. Bone Marrow Transplant. 2013;48(12):1569–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Dominietto A, Raiola AM, van Lint MT, Lamparelli T, Gualandi F, Berisso G, et al. Factors influencing haematological recovery after allogeneic haemopoietic stem cell transplants: graft-versus-host disease, donor type, cytomegalovirus infections and cell dose. Br J Haematol. 2001;112:219–27.

    Article  CAS  PubMed  Google Scholar 

  7. Bruno B, Gooley T, Sullivan KM, Sullivan KM, Davis C, Bensinger WI, Storb R, et al. Secondary failure of platelet recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2001;7:154–62.

    Article  CAS  PubMed  Google Scholar 

  8. Przepiorka D, Anderlini P, Saliba R, Cleary K, Mehra R, Khouri I, et al. Chronic graft-versus-host disease after allogeneic blood stem cell transplantation. Blood. 2001;98:1695–700.

    Article  CAS  PubMed  Google Scholar 

  9. First LR, Smith BR, Lipton J, Nathan DG, Parkman R, Rappeport JM. Isolated thrombocytopenia after allogeneic bone marrow transplantation: existence of transient and chronic thrombocytopenic syndromes. Blood. 1985;65:368–74.

    CAS  PubMed  Google Scholar 

  10. Bolwell B, Pohlman B, Sobecks R, Andresen S, Brown S, Rybicki L, et al. Prognostic importance of the platelet count 100 days post allogeneic bone marrow transplant. Bone Marrow Transplant. 2004;33:419–23.

    Article  CAS  PubMed  Google Scholar 

  11. Makar RSL, Zhukov OS, Sahud MA, Kuter DJ. Thrombopoietin levels in patients with disorders of platelet production: diagnostic potential and utility in predicting response to TPO receptor agonists. Am J Hematol. 2013;88(12):1041–4.

    Article  CAS  PubMed  Google Scholar 

  12. Buchbinder D, Hsieh L, Krance R, Nugent DJ. Successful treatment of post-transplant thrombocytopenia with romiplostim in a pediatric patient with X-linked chronic granulomatous disease. Pediatr Transplantation. 2014;18(7):E252–4.

    Article  Google Scholar 

  13. Calmettes C, Vigouroux S, Tabrizi R, Milpied N. Romiplostim (AMG531, Nplate) for secondary failure of platelet recovery after allo-SCT. Bone Marrow Transplant. 2011;46:1587–9.

    Article  CAS  PubMed  Google Scholar 

  14. Bollag RJ, Sterett M, Reding MT, Key NS, Cohn CS, Ustun C. Response of complex immune-mediated thrombocytopenia to romiplostim in the setting of allogeneic stem cell transplantation for chronic myelogenous leukemia. Eur J Haematol. 2012;89:361–4.

    Article  PubMed  Google Scholar 

  15. Kuter DJ, Gernsheimer TB. Thrombopoietin and platelet production in chronic immune thrombocytopenia. Hematol Oncol Clin North Am. 2009;23(6):1193–211.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Harker LA, Carter RA, Marzec UM, Cherry JK, Gunthel CJ, Lennox JL, et al. Correction of thrombocytopenia and ineffective platelet production in patients infected with human immunodeficiency virus (HIV) by PEG-rHuMGDF therapy [abstract]. Blood. 1998;92:707a.

    Google Scholar 

  17. Xiao Y, Lin W, Liu Q, Jin R, Fei H. Direct infection of colony forming unit-megakaryocytes by human cytomegalovirus contributes the pathogenesis of idiopathic thrombocytopenic purpura. J Huazhong Univ Sci Technol. 2006;26(5):555–7.

    Article  CAS  Google Scholar 

  18. First LR, Smith BR, Lipton J, Nathan DG, Parkman R, Rappeport JM. Isolated thrombocytopenia after allogeneic bone marrow transplantation: existence of transient and chronic thrombocytopenic syndromes. Blood. 1985;65(2):368–74.

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors received no financial support for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Bone Marrow Transplantation Unit, Pediatric Hemato Oncology Department, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell’Istria 65, 34134, Trieste, Italy

    Natalia Maximova

  2. Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Pharmacy and Clinical Pharmacology, Trieste, Italy

    D. Zanon, F. Rovere, A. Maestro, G. Schillani & R. Paparazzo

Authors
  1. Natalia Maximova
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  2. D. Zanon
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  3. F. Rovere
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  4. A. Maestro
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  5. G. Schillani
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  6. R. Paparazzo
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Corresponding author

Correspondence to Natalia Maximova.

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Maximova, N., Zanon, D., Rovere, F. et al. Romiplostim for secondary thrombocytopenia following allogeneic stem cell transplantation in children. Int J Hematol 102, 626–632 (2015). https://doi.org/10.1007/s12185-015-1821-1

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  • DOI: https://doi.org/10.1007/s12185-015-1821-1

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