International Journal of Hematology

, Volume 110, Issue 2, pp 255–259 | Cite as

Glucocorticoids promote response to thrombopoietin-receptor agonists in refractory ITP: a case series

  • Jacqueline N. Poston
  • Terry B. GernsheimerEmail author
Case Report


A proportion of patients with immune thrombocytopenic purpura are refractory to multiple therapies including thrombopoietin-receptor agonists (TPO-RA). We report 10 patients who did not respond to a TPO-RA until the addition of a glucocorticoid. These patients were previously treated with a median of 6 therapies. One patient elected to discontinue both medications despite persistent thrombocytopenia. The remaining 9 patients continued on the combination of prednisone (doses 5 mg every other day to 10 mg daily) and a TPO-RA. Combination therapy with low dose glucocorticoid and a TPO-RA may be an option for patients unresponsive to a TPO-RA alone.


Autoimmune thrombocytopenia Immune thrombocytopenic purpura Refractory Thrombopoietin-receptor agonists Glucocorticoids 



Jacqueline N. Poston receives support from an Institutional Training Grant from the National Heart, Lung, and Blood Institute (T32 HL007093).

Author contributions

JNP and TBG co-wrote the manuscript. JNP analyzed the data.

Compliance with ethical standards

Conflict of interest

Jacqueline N. Poston has no conflicts of interest to disclose. Terry B. Gernsheimer has been a consultant for Amgen and Novartis.


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Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  1. 1.Division of Hematology, Department of MedicineUniversity of WashingtonSeattleUSA
  2. 2.Seattle Cancer Care AllianceSeattleUSA
  3. 3.Bloodworks NW Research InstituteSeattleUSA
  4. 4.Fred Hutchinson Cancer Research CenterSeattleUSA

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