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Persistent elevation of plasma thrombopoietin levels after treatment in severe aplastic anemia.

Abstract
Although hematopoietic growth factors are found at high levels in aplastic anemia (AA) patients, little is known about their dynamic change over time after treatment. We examined plasma concentrations of hematopoietic growth factors sequentially in 55 severe AA patients, including 45 treatment-naive patients who had received immunosuppressive therapy (IST) or IST and eltrombopag, and 10 IST-refractory patients who had received eltrombopag only, focusing on thrombopoietin (TPO). TPO concentrations were much higher than normal in patients before treatment and then decreased in responders but not in nonresponders. We followed up on a cohort of nine patients who obtained stable complete remission for up to 7 years after IST and found that TPO levels declined gradually by 3 months after treatment, accompanying an increase in platelet counts, but stabilized at levels higher than normal. An inverse correlation was noted between TPO levels and platelet counts. The increased plasma TPO levels could be required to maintain normal platelet counts in remission and could also be attributed to reduced consumption by circulating platelets.
AuthorsXin Zhao, Xingmin Feng, Zhijie Wu, Thomas Winkler, Ronan Desmond, Matthew Olnes, Bogdan Dumitriu, Danielle M Townsley, Cynthia E Dunbar, Neal S Young
JournalExperimental hematology (Exp Hematol) Vol. 58 Pg. 39-43 (02 2018) ISSN: 1873-2399 [Electronic] Netherlands
PMID28941711 (Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Intramural)
CopyrightPublished by Elsevier Inc.
Chemical References
  • Benzoates
  • Hydrazines
  • Pyrazoles
  • Thrombopoietin
  • eltrombopag
Topics
  • Adolescent
  • Adult
  • Aged
  • Anemia, Aplastic (blood, drug therapy)
  • Benzoates (administration & dosage)
  • Child
  • Female
  • Humans
  • Hydrazines (administration & dosage)
  • Immunosuppression Therapy
  • Male
  • Middle Aged
  • Platelet Count
  • Pyrazoles (administration & dosage)
  • Severity of Illness Index
  • Thrombopoietin (blood)
  • Time Factors

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