[Efficacy and safety of romiplostim in aplastic anemia refractory or intolerant to immunosuppressive therapy with eltrombopag].

Shuku Sato, Shun Tsunoda, Wataru Kamata, Tomiteru Togano, Yotaro Tamai
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Abstract

Combination of immunosuppressive therapy (IST) and thrombopoietin receptor agonists has revolutionized the treatment of aplastic anemia. In this study, 18 patients with eltrombopag (EPAG)-refractory and intolerant AA, including 16 with severe AA, were switched from EPAG to romiplostim and continued with romiplostim for at least three months. Of the 18 patients (7 refractory and 11 intolerant to EPAG), 13 (72%) achieved a response, with a therapeutic response in at least one lineage within three months, and nine patients (50%) showed a trilineage response. All three patients who started romiplostim over three years after diagnosis failed to respond to romiplostim. In three of the four patients with adequate response to romiplostim, interruption of romiplostim resulted in relapsed thrombocytopenia, and early resumption of romiplostim resulted in recovered blood counts. These results suggest that romiplostim may achieve a response in IST+EPAG refractory/intolerant SAA.

[romiplostim治疗再生障碍性贫血的疗效和安全性]。
免疫抑制疗法(IST)和血小板生成素受体激动剂的联合使用彻底改变了再生障碍性贫血的治疗。在本研究中,18例EPAG难治性不耐受AA患者,包括16例重度AA患者,从EPAG切换到romiplostim,并继续使用romiplostim至少3个月。在18例患者(7例难治性和11例对EPAG不耐受)中,13例(72%)获得了缓解,至少在三个月内有一个谱系的治疗反应,9例(50%)显示了三期缓解。所有三名在诊断后三年内开始使用罗米洛stim的患者均未能对罗米洛stim产生反应。在对罗米plostim有充分反应的4例患者中,有3例中断使用罗米plostim导致血小板减少症复发,而早期恢复使用罗米plostim导致血细胞计数恢复。这些结果表明,在IST+EPAG难治性/不耐受性SAA中,罗米plostim可能达到应答。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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