Sequential Use of Romiplostim after Eltrombopag for Refractory Thrombocytopenia in Hydrocarbon-Induced Myelodysplasia
| Autor: | Rishabh C. Choudhary, Gabriel I. Aranalde, Muhammad Shoaib, Elena C. Brindley, Elvio Mazzotta, Sara Guevara, Alexia McCann-Molmenti, Young Min Cho, Stefanos Zafeiropoulos, Stacey Watt, Yaser M. Alsalmay, Kei Hayashida, Lance B Becker, Koichiro Shinozaki, Luis F. Morales, Stavros Zanos, Christine N. Metz, Ernesto P. Molmenti, Ryosuke Takegawa, Daniel A. Grande, Santiago J. Miyara, Mitsuaki Nishikimi, Adam M. Kressel |
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| Rok vydání: | 2021 |
| Předmět: |
Thrombopoietin receptor
Pediatrics medicine.medical_specialty Romiplostim business.industry Myelodysplastic syndromes Eltrombopag medicine.disease Thrombocytopenic purpura law.invention chemistry.chemical_compound Randomized controlled trial Refractory chemistry law hemic and lymphatic diseases Medicine Refractory Thrombocytopenia Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | International Journal of Angiology. |
| ISSN: | 1615-5939 1061-1711 |
| Popis: | We describe the clinical course of a 65-year-old male patient who suffered from hydrocarbon-induced myelodysplasia and was successfully treated with the thrombopoietin receptor agonist (TPO-RA), romiplostim. Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis, cytopenias, and increased risk of leukemic transformation. Here, we present a clinical vignette of MDS-associated thrombocytopenia refractory to first-line drugs as well as the TPO-RA, eltrombopag. To date, romiplostim is an U.S. Food and Drug Administration (FDA)-approved drug for idiopathic thrombocytopenic purpura and thrombocytopenia secondary to liver disease. Of note, currently the FDA advises against its use in MDS based on previous long-term safety concerns. Since the therapeutic options for thrombocytopenia in MDS patients are sparse, repurposing and reassessing romiplostim in this setting have been the focus of recent studies. At the time of writing, no published double-blind randomized clinical trials have conducted a head-to-head comparison between romiplostim and eltrombopag in thrombocytopenic MDS patients. To the best of our knowledge, for a thrombocytopenic patient in the setting of MDS, this is the first documented report of refractory clinical response after a 2-year use of eltrombopag in which replacement of treatment with romiplostim resulted in sustained physiological counts of thrombocytes within four weeks. |
| Databáze: | OpenAIRE |
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