Use of eltrombopag for secondary immune thrombocytopenia in clinical practice

被引：35

作者：

Gonzalez-Lopez, Tomas J. ^{[1
]}

Alvarez-Roman, Maria T. ^{[2
]}

Pascual, Cristina ^{[3
]}

Sanchez-Gonzalez, Blanca ^{[4
]}

Fernandez-Fuentes, Fernando ^{[5
]}

Perez-Rus, Gloria ^{[3
]}

Hernandez-Rivas, Jose A. ^{[6
]}

Bernat, Silvia ^{[7
]}

Bastida, Jose M. ^{[8
]}

Martinez-Badas, Maria P. ^{[9
]}

Martinez-Robles, Violeta ^{[10
]}

Soto, Inmaculada ^{[11
]}

Olivera, Pavel ^{[12
]}

Bolanos, Estefania ^{[13
]}

Alonso, Rafael ^{[14
]}

Entrena, Laura ^{[15
]}

Gomez-Nunez, Marta ^{[16
]}

Alonso, Arancha ^{[17
]}

Cobo, Maria Yera ^{[18
]}

Caparros, Isabel ^{[19
]}

Tenorio, Maria ^{[20
]}

Arrieta-Cerdan, Esther ^{[21
]}

Lopez-Ansoar, Elsa ^{[22
]}

Garcia-Frade, Javier ^{[23
]}

Gonzalez-Porras, Jose R. ^{[8
]}

机构：

[1] Hosp Univ Burgos, Dept Haematol, Burgos, Spain

[2] Hosp Univ La Paz, Dept Haematol, Madrid, Spain

[3] Hosp Univ Gregorio Maranon, Dept Haematol, Madrid, Spain

[4] Hosp del Mar, Dept Haematol, Barcelona, Spain

[5] Hosp Univ Insular Gran Canaria, Dept Haematol, Las Palmas Gran Canaria, Spain

[6] Hosp Infanta Leonor, Dept Haematol, Madrid, Spain

[7] Hosp La Plana, Dept Haematol, Castellon de La Plana, Spain

[8] IBSAL Hosp Univ Salamanca, Dept Haematol, Salamanca, Spain

[9] Hosp Avila, Dept Haematol, Avila, Spain

[10] Hosp Leon, Dept Haematol, Leon, Spain

[11] Hosp Univ Cent Asturias, Dept Haematol, Oviedo, Spain

[12] Hosp Univ Valle Hebron, Dept Haematol, Barcelona, Spain

[13] Hosp Univ Clin San Carlos, Dept Haematol, Madrid, Spain

[14] Hosp Univ Doce Octubre, Dept Haematol, Madrid, Spain

[15] Hosp Univ Virgen Nieves, Dept Haematol, Granada, Spain

[16] Dept Haematol, Parc Sanit Tauli, Sabadell, Barcelona, Spain

[17] Hosp Univ Quiron Madrid, Dept Haematol, Madrid, Spain

[18] Hosp Puerta Mar, Dept Haematol, Cadiz, Spain

[19] Hosp Clin Malaga, Dept Haematol, Malaga, Spain

[20] Hosp Univ Ramon y Cajal, Dept Haematol, Madrid, Spain

[21] Hospi Univ Burgos, Dept Stat, Burgos, Spain

[22] Complejo Hosp Univ Orense, Dept Haematol, Orense, Spain

[23] Hosp Univ Rio Hortega, Dept Haematol, Valladolid, Spain

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2017年 / 178卷 / 06期

关键词：

immune thrombocytopenia; thrombopoietin; eltrombopag; efficacy; safety; SYSTEMIC-LUPUS-ERYTHEMATOSUS; CHRONIC LYMPHOCYTIC-LEUKEMIA; THROMBOPOIETIN-RECEPTOR AGONISTS; ROMIPLOSTIM; EFFICACY; PURPURA; SPLENECTOMY; MANAGEMENT; DISORDERS; RITUXIMAB;

D O I：

10.1111/bjh.14788

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated. Forty-four patients (38%) had a platelet response, including 40 (35%) with complete responses. Median time to platelet response was 15 days (95% confidence interval, 7-28 days), and was longer in the LPD-ITP group. Platelet response rate was significantly lower in the LPD-ITP than in other groups. However, having achieved response, there were no significant differences between the durable response of the groups. Forty-three patients (49.4%) experienced adverse events (mainly grade 1-2), the commonest being hepatobiliary laboratory abnormalities. There were 10 deaths in this case series, all of which were related to pre-existing medical conditions. In routine clinical practice, eltrombopag is effective and well-tolerated in unselected patients with ITP secondary to both immune and infectious disorders. However, the response rate in LPD-ITP is low.

引用

页码：959 / 970

页数：12

共 34 条

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