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Rapid blood cell recovery with immunosuppressive therapy combined with romiplostim in a patient with very severe hepatitis-associated aplastic anemia who underwent liver transplantation

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Abstract

Patients with hepatitis-associated aplastic anemia (HAA) who undergo living-donor liver transplantation (LDLT) have a poor prognosis with infections and bleeding complications. Rapid recovery of blood cells is critical for preventing these complications and improving the outcome. Immunosuppressive therapy (IST) combined with thrombopoietin receptor agonists is considered effective for aplastic anemia. However, there are no data on the benefits of adding thrombopoietin receptor agonists to IST for HAA. We present the case of a child with severe HAA who underwent LDLT, and who achieved rapid blood cell recovery with IST combined with romiplostim, a thrombopoietin receptor agonist. In addition, despite having undergone LDLT, the patient had no adverse events such as serious liver dysfunction or thrombosis. This case suggests that IST combined with thrombopoietin receptor agonists may be a promising treatment option for HAA patients undergoing LDLT.

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Authors and Affiliations

  1. Department of Pediatrics, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Hiroki Yoshinari, Yuta Kawahara, Hitomi Niijima, Yukiko Oh & Akira Morimoto

  2. Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke, Japan

    Yuta Hirata, Noriki Okada, Yukihiro Sanada, Yasuharu Onishi & Yasunaru Sakuma

Authors
  1. Hiroki Yoshinari
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  2. Yuta Kawahara
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  3. Hitomi Niijima
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  4. Yukiko Oh
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  5. Yuta Hirata
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  6. Noriki Okada
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  7. Yukihiro Sanada
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  8. Yasuharu Onishi
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  9. Yasunaru Sakuma
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  10. Akira Morimoto
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Contributions

HY, YK, YS, and AM wrote the manuscript. YK, HN, YO, YH, NO, YS, YO, YS, and A.M. provided medical care for the patient. All authors commented on the manuscript and contributed to the final manuscript.

Corresponding author

Correspondence to Yuta Kawahara.

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Conflict of interest

The authors declare no conflicts of interest in association with the present study.

Informed consent

Written informed consent for the off-label use of romiplostim was obtained from the parents.

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Yoshinari, H., Kawahara, Y., Niijima, H. et al. Rapid blood cell recovery with immunosuppressive therapy combined with romiplostim in a patient with very severe hepatitis-associated aplastic anemia who underwent liver transplantation. Int J Hematol 114, 524–527 (2021). https://doi.org/10.1007/s12185-021-03165-z

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  • DOI: https://doi.org/10.1007/s12185-021-03165-z

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