EFFICACY OF TPO-MIMETICS IN PATIENTS WITH CHRONIC IMMUNE THROMBOCYTOPENIA
(Abstract release date: 05/19/16)
EHA Library. Bacchiarri F. 06/09/16; 134988; PB2088
Dr. Francesca Bacchiarri
Contributions
Contributions
Abstract
Abstract: PB2088
Type: Publication Only
Background
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder in which antibodies are produced to circulating platelets. The isolation of TPO and better understanding of its role in thrombopoiesis has led to the development of new highly effective tTPO analogs had some successes in treating highly refractory ITP patients but were taken out of development due to TPO-antibody induction.
Aims
The aim of this study is to describe our experience with thrombopoietin receptor agonists (TPO-RA).
Methods
From November 2008 and April 2015 54 patients (29 M; 25 F) were treated with TPO-mimetics: 38 underwent therapy with Romiplostim and 16 to Eltrombopag. Median age was 71 years (range 39-94 years). 8/54 (14%) patients received both of therapies: 5 (4 F; 1 M) switched from Romiplostim to Eltrombopag and 3 (3 M) switched from Eltrombopag to Romiplostim.
Results
In the group of patients treated with Romiplostim, 16/38 had already received more than 4 lines of therapy, while 10 were at the 3rd line of therapy, and 5 were at 2nd line. Only 2/16 patients who received Eltrombopag were at the 2nd line of therapy, and the others were at least at the 3rd line. The median platelet count was 17.000/µl at the start of Romiplostim and 10.000/µl in patients treated with Eltrombopag.With median follow-up of 36 months (4-74), we observed 33 responses (86%) with Romiplostim (19 complete response, 14 partial response) and 5 no responders; we had also 3 loss of response.In our study 18 (33%) patients stopped Romiplostim after a median time of 23 months (1-56): 6 for stable response; 2 for adverse events; 3 for loss of response; 2 underwent splenectomy; 5 for no response. The median platelet count at suspension of Romiplostim was 94.000/µl (2.000-739.000); the patients discontinued Romiplostim after a median time of 26,6 months. Now 7 patients are out of treatment with a stable platelet count (median time after discontinuation: 25 months).In patients treated with Eltrombopag 13 (81%) achieved a response (9 complete response, 4 partial response), 3 were no responders. 11 (69%) patients stopped Eltrombopag after a median time of 10 months (1-16): 5 for adverse events; 3 for no response; 2 for stable response; 1 for splenectomy. The median platelet count at suspension was 74.000/µl (2.000-739.000); the patients discontinued Eltrombopag after a median time of 11,1 months and now are out of treatment from 3 months.
Conclusion
Several studies reported Romiplostim and Eltrombopag to be highly effective against chronic ITP, with average immediate responses exceeding 80% in our study.TPO-mimetics have proved efficacy in patients with ITP and their use can be applied in several conditions: bridge to splenectomy, sustained response, switch and discontinuation.
Session topic: E-poster
Keyword(s): Bleeding disorder, Chronic ITP, Immune thrombocytopenia (ITP), TPO
Type: Publication Only
Background
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder in which antibodies are produced to circulating platelets. The isolation of TPO and better understanding of its role in thrombopoiesis has led to the development of new highly effective tTPO analogs had some successes in treating highly refractory ITP patients but were taken out of development due to TPO-antibody induction.
Aims
The aim of this study is to describe our experience with thrombopoietin receptor agonists (TPO-RA).
Methods
From November 2008 and April 2015 54 patients (29 M; 25 F) were treated with TPO-mimetics: 38 underwent therapy with Romiplostim and 16 to Eltrombopag. Median age was 71 years (range 39-94 years). 8/54 (14%) patients received both of therapies: 5 (4 F; 1 M) switched from Romiplostim to Eltrombopag and 3 (3 M) switched from Eltrombopag to Romiplostim.
Results
In the group of patients treated with Romiplostim, 16/38 had already received more than 4 lines of therapy, while 10 were at the 3rd line of therapy, and 5 were at 2nd line. Only 2/16 patients who received Eltrombopag were at the 2nd line of therapy, and the others were at least at the 3rd line. The median platelet count was 17.000/µl at the start of Romiplostim and 10.000/µl in patients treated with Eltrombopag.With median follow-up of 36 months (4-74), we observed 33 responses (86%) with Romiplostim (19 complete response, 14 partial response) and 5 no responders; we had also 3 loss of response.In our study 18 (33%) patients stopped Romiplostim after a median time of 23 months (1-56): 6 for stable response; 2 for adverse events; 3 for loss of response; 2 underwent splenectomy; 5 for no response. The median platelet count at suspension of Romiplostim was 94.000/µl (2.000-739.000); the patients discontinued Romiplostim after a median time of 26,6 months. Now 7 patients are out of treatment with a stable platelet count (median time after discontinuation: 25 months).In patients treated with Eltrombopag 13 (81%) achieved a response (9 complete response, 4 partial response), 3 were no responders. 11 (69%) patients stopped Eltrombopag after a median time of 10 months (1-16): 5 for adverse events; 3 for no response; 2 for stable response; 1 for splenectomy. The median platelet count at suspension was 74.000/µl (2.000-739.000); the patients discontinued Eltrombopag after a median time of 11,1 months and now are out of treatment from 3 months.
Conclusion
Several studies reported Romiplostim and Eltrombopag to be highly effective against chronic ITP, with average immediate responses exceeding 80% in our study.TPO-mimetics have proved efficacy in patients with ITP and their use can be applied in several conditions: bridge to splenectomy, sustained response, switch and discontinuation.
Session topic: E-poster
Keyword(s): Bleeding disorder, Chronic ITP, Immune thrombocytopenia (ITP), TPO
Abstract: PB2088
Type: Publication Only
Background
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder in which antibodies are produced to circulating platelets. The isolation of TPO and better understanding of its role in thrombopoiesis has led to the development of new highly effective tTPO analogs had some successes in treating highly refractory ITP patients but were taken out of development due to TPO-antibody induction.
Aims
The aim of this study is to describe our experience with thrombopoietin receptor agonists (TPO-RA).
Methods
From November 2008 and April 2015 54 patients (29 M; 25 F) were treated with TPO-mimetics: 38 underwent therapy with Romiplostim and 16 to Eltrombopag. Median age was 71 years (range 39-94 years). 8/54 (14%) patients received both of therapies: 5 (4 F; 1 M) switched from Romiplostim to Eltrombopag and 3 (3 M) switched from Eltrombopag to Romiplostim.
Results
In the group of patients treated with Romiplostim, 16/38 had already received more than 4 lines of therapy, while 10 were at the 3rd line of therapy, and 5 were at 2nd line. Only 2/16 patients who received Eltrombopag were at the 2nd line of therapy, and the others were at least at the 3rd line. The median platelet count was 17.000/µl at the start of Romiplostim and 10.000/µl in patients treated with Eltrombopag.With median follow-up of 36 months (4-74), we observed 33 responses (86%) with Romiplostim (19 complete response, 14 partial response) and 5 no responders; we had also 3 loss of response.In our study 18 (33%) patients stopped Romiplostim after a median time of 23 months (1-56): 6 for stable response; 2 for adverse events; 3 for loss of response; 2 underwent splenectomy; 5 for no response. The median platelet count at suspension of Romiplostim was 94.000/µl (2.000-739.000); the patients discontinued Romiplostim after a median time of 26,6 months. Now 7 patients are out of treatment with a stable platelet count (median time after discontinuation: 25 months).In patients treated with Eltrombopag 13 (81%) achieved a response (9 complete response, 4 partial response), 3 were no responders. 11 (69%) patients stopped Eltrombopag after a median time of 10 months (1-16): 5 for adverse events; 3 for no response; 2 for stable response; 1 for splenectomy. The median platelet count at suspension was 74.000/µl (2.000-739.000); the patients discontinued Eltrombopag after a median time of 11,1 months and now are out of treatment from 3 months.
Conclusion
Several studies reported Romiplostim and Eltrombopag to be highly effective against chronic ITP, with average immediate responses exceeding 80% in our study.TPO-mimetics have proved efficacy in patients with ITP and their use can be applied in several conditions: bridge to splenectomy, sustained response, switch and discontinuation.
Session topic: E-poster
Keyword(s): Bleeding disorder, Chronic ITP, Immune thrombocytopenia (ITP), TPO
Type: Publication Only
Background
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder in which antibodies are produced to circulating platelets. The isolation of TPO and better understanding of its role in thrombopoiesis has led to the development of new highly effective tTPO analogs had some successes in treating highly refractory ITP patients but were taken out of development due to TPO-antibody induction.
Aims
The aim of this study is to describe our experience with thrombopoietin receptor agonists (TPO-RA).
Methods
From November 2008 and April 2015 54 patients (29 M; 25 F) were treated with TPO-mimetics: 38 underwent therapy with Romiplostim and 16 to Eltrombopag. Median age was 71 years (range 39-94 years). 8/54 (14%) patients received both of therapies: 5 (4 F; 1 M) switched from Romiplostim to Eltrombopag and 3 (3 M) switched from Eltrombopag to Romiplostim.
Results
In the group of patients treated with Romiplostim, 16/38 had already received more than 4 lines of therapy, while 10 were at the 3rd line of therapy, and 5 were at 2nd line. Only 2/16 patients who received Eltrombopag were at the 2nd line of therapy, and the others were at least at the 3rd line. The median platelet count was 17.000/µl at the start of Romiplostim and 10.000/µl in patients treated with Eltrombopag.With median follow-up of 36 months (4-74), we observed 33 responses (86%) with Romiplostim (19 complete response, 14 partial response) and 5 no responders; we had also 3 loss of response.In our study 18 (33%) patients stopped Romiplostim after a median time of 23 months (1-56): 6 for stable response; 2 for adverse events; 3 for loss of response; 2 underwent splenectomy; 5 for no response. The median platelet count at suspension of Romiplostim was 94.000/µl (2.000-739.000); the patients discontinued Romiplostim after a median time of 26,6 months. Now 7 patients are out of treatment with a stable platelet count (median time after discontinuation: 25 months).In patients treated with Eltrombopag 13 (81%) achieved a response (9 complete response, 4 partial response), 3 were no responders. 11 (69%) patients stopped Eltrombopag after a median time of 10 months (1-16): 5 for adverse events; 3 for no response; 2 for stable response; 1 for splenectomy. The median platelet count at suspension was 74.000/µl (2.000-739.000); the patients discontinued Eltrombopag after a median time of 11,1 months and now are out of treatment from 3 months.
Conclusion
Several studies reported Romiplostim and Eltrombopag to be highly effective against chronic ITP, with average immediate responses exceeding 80% in our study.TPO-mimetics have proved efficacy in patients with ITP and their use can be applied in several conditions: bridge to splenectomy, sustained response, switch and discontinuation.
Session topic: E-poster
Keyword(s): Bleeding disorder, Chronic ITP, Immune thrombocytopenia (ITP), TPO
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