Thrombopoietin receptor agonists for preparing adult patients with immune thrombocytopenia to splenectomy: results of a retrospective, observational GIMEMA study

American Journal of Hematology
F ZajaRenato Fanin

Abstract

In patients with immune thrombocytopenia (ITP) refractory to corticosteroids and intravenous immunoglobulins (IVIG), splenectomy may result at higher risk of peri-operative complications and, for this reason, potentially contraindicated. The thrombopoietin receptor agonists (TPO-RAs) romiplostim and eltrombopag have shown high therapeutic activity in primary ITP, but data of efficacy and safety regarding their use in preparation for splenectomy are missing. Thirty-one adult patients, median age 50 years, with corticosteroids and/or IVIG refractory persistent and chronic ITP who were treated with TPO-RAs (romiplostim= 24; eltrombopag= 7) with the aim to increase platelet count and allow a safer execution of splenectomy were retrospectively evaluated. Twenty-four patients (77%) responded to the use of TPO-RAs with a median platelet count that increased from 11 × 10(9) /L before starting TPO-RAs to 114 × 10(9) /L pre-splenectomy, but a concomitant treatment with corticosteroids and/or IVIG was required in 19 patients. Twenty-nine patients underwent splenectomy while two patients who responded to TPO-RAs subsequently refused surgery. Post-splenectomy complications were characterized by two Grade 3 thrombotic events (1 portal vein t...Continue Reading

References

Aug 2, 2012·Journal of Gastroenterology and Hepatology·Mohamed M Moussa, Nadia Mowafy
Aug 24, 2012·The New England Journal of Medicine·Nezam H AfdhalUNKNOWN ELEVATE Study Group
Nov 7, 2012·Acta Haematologica·Tadashi UwagawaKatsuhiko Yanaga
Jun 3, 2015·Transfusion·Ariela L MarshallDavid J Kuter

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Citations

Dec 23, 2017·Pediatrics International : Official Journal of the Japan Pediatric Society·Miyako KannoTetsuo Mitsui
Jul 2, 2019·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Fabrizio VianelloGianfranco Da Dalt
Jan 4, 2020·International Journal of Hematology·Hirokazu KashiwagiUNKNOWN Committee for the Revision of “Reference Guide for Management of adult ITP” Blood Coagulation Abnormalities Research Team, R
Dec 16, 2017·European Journal of Haematology·Jacopo Agnelli GiacchelloAlessandra Borchiellini
Dec 20, 2019·Annals of Hematology·Shoko ItoYoshinobu Kanda
Mar 16, 2017·British Journal of Haematology·Alice TaylorMarie Scully
Dec 1, 2020·Expert Review of Hematology·Maria L LozanoDavid J Kuter
Jul 28, 2020·La Revue de médecine interne·M EbboB Godeau
Mar 17, 2021·Expert Review of Clinical Pharmacology·Rajeev SandalAhmad Daniyal Siddiqui
Nov 2, 2021·Expert Review of Hematology·James BusselAdrian Newland

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