Sustained remission of chronic immune thrombocytopenia after discontinuation of treatment with thrombopoietin-receptor agonists in adults.

Abstract

Thrombopoietin-receptor agonists (TPO-RAs) are highly effective in immune thrombocytopenia (ITP). Recently, reports of sustained remission after TPO-RA discontinuation in adult ITP have been reported. We aimed to describe the subset of patients in whom TPO-RA therapy may induce a durable response. We retrospectively analyzed all of our adult ITP patients treated with TPO-RAs, and focused on patients with discontinued TPO-RA therapy due to treatment response. Forty-six relapsed or refractory ITP patients were treated with TPO-RAs. In 11 of these cases, TPO-RA therapy (seven romiplostim; four eltrombopag) was stopped after achieving treatment response. No side effects of TPO-RAs were observed. These patients were pretreated with 1-3 therapy lines plus splenectomy in six patients prior to TPO-RA administration. None of these patients experienced disease relapse after therapy discontinuation over a median follow-up of 33 months (16-54). Substantial proportion of ITP patients receiving TPO-RAs can maintain a durable response after treatment discontinuation. Sustained ITP remission probably does not depend on previous treatment, splenectomy, or disease duration.

• Authors: Libor Červinek, Jiří Mayer, Michael Doubek
• Journal: International journal of hematology (Int J Hematol) Vol. 102 Issue 1 Pg. 7-11 (Jul 2015) ISSN: 1865-3774 [Electronic] Japan
• PMID: 25833724 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Receptors, Fc
• Receptors, Thrombopoietin
• Recombinant Fusion Proteins
• Thrombopoietin
• romiplostim

Topics

• Adult
• Aged
• Chronic Disease
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Platelet Count
• Purpura, Thrombocytopenic, Idiopathic (drug therapy, metabolism)
• Receptors, Fc (therapeutic use)
• Receptors, Thrombopoietin (agonists)
• Recombinant Fusion Proteins (therapeutic use)
• Recurrence
• Retrospective Studies
• Thrombopoietin (therapeutic use)
• Treatment Outcome