Romiplostim resistance in secondary failure of platelet recovery
| Autor: | Farrukh T. Awan, David L. DeRemer, Katerina Katsanevas, Amber M. Bradley |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Male medicine.medical_specialty Chronic lymphocytic leukemia Recombinant Fusion Proteins Drug Resistance Receptors Fc Refractory hemic and lymphatic diseases Internal medicine medicine Humans Pharmacology (medical) Thrombopoietin Romiplostim biology Dose-Response Relationship Drug Platelet recovery business.industry Platelet Count Middle Aged medicine.disease Leukemia Lymphocytic Chronic B-Cell Thrombocytopenia medicine.anatomical_structure Immunology biology.protein Bone marrow Stem cell Antibody business medicine.drug Stem Cell Transplantation |
| Zdroj: | Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 19(4) |
| ISSN: | 1477-092X |
| Popis: | Romiplostim, a thrombopoietin mimetic, is FDA approved for the treatment of thrombocytopenia in patients with refractory immune thrombocytopenia. Given the success of thrombopoietin agonists in the treatment of immune thrombocytopenia, data in other clinical settings are emerging. In the bone marrow transplant setting, secondary failure of platelet recovery and persistent thrombocytopenia are associated with increased mortality. In this case, romiplostim was attempted in a chronic lymphocytic leukemia patient who underwent a matched, unrelated donor, non-myeloablative stem cell transplant. This patient experienced profound thrombocytopenia despite dose escalation. Anti-thrombopoietin or anti-romiplostim antibodies were not detected by specific assays. Furthermore, the patient remains in disease remission with full chimerism. This case demonstrates that heavily pre-treated patients with limited bone marrow reserve may not respond to thrombopoietin agonists. |
| Databáze: | OpenAIRE |
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