Combination of two target agonists of the thrombopoietin and thrombopoietin receptor in the treatment of elderly patients with refractory immune thrombocytopenia

Cancer pathogenesis and therapy Pub Date : 2023-04-01 DOI:10.1016/j.cpt.2022.09.005

Jundong Zhang , Zining Wang , Haoran Chen , Xuechun Lu

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Abstract

Immune thrombocytopenia (ITP) is common in the elderly. Because of the coexistence of multiple diseases, there are many reservations regarding corticosteroid use in the elderly. Thrombopoietin (TPO) and its analogs can promote platelet production, but it is often difficult to correct TP in a short period. Recombinant human TPO (rh-TPO) acting on the cell membrane and the small-molecule TPO-receptor (MPL) agonist acting on the transmembrane receptor may have synergistic effects and accelerate platelet production because of different sites of action in the signaling pathway. In this study, two elderly patients with refractory ITP were successfully treated with two TPO-MPL signaling pathway agonists: recombinant human thrombopoietin (rh-TPO) and eltrombopag. This combination is safe with rapid and lasting effects. However, in elderly patients with refractory, recurrent, and glucocorticoid contraindications, the combination of different TPO agonists' clinical efficacy and adverse reactions needs to be further evaluated.

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血小板生成素和血小板生成素受体两种靶向激动剂联合治疗老年难治性免疫性血小板减少症

免疫性血小板减少症（ITP）在老年人中很常见。由于多种疾病共存，对老年人使用皮质类固醇有许多保留意见。血小板生成素（TPO）及其类似物可以促进血小板的产生，但通常很难在短时间内纠正TP。作用于细胞膜的重组人TPO（rh-TPO）和作用于跨膜受体的小分子TPO受体（MPL）激动剂可能具有协同作用，并由于信号通路中的作用位点不同而加速血小板产生。在本研究中，两名患有难治性ITP的老年患者成功地使用了两种TPO-MPL信号通路激动剂：重组人血小板生成素（rh-TPO）和艾曲波帕。这种组合是安全的，具有快速和持久的效果。然而，在有难治性、复发性和糖皮质激素禁忌症的老年患者中，不同TPO激动剂的联合临床疗效和不良反应需要进一步评估。

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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