HIGH-DOSE DEXAMETHASONE AND ELTROMBOPAG IN CHRONIC IMMUNE THROMBOCYTOPENIA: A SINGLE INSTITUTION EXPERIENCE.
(Abstract release date: 05/19/16)
EHA Library. Molica S. 06/09/16; 134990; PB2090
Dr. Stefano Molica
Contributions
Contributions
Abstract
Abstract: PB2090
Type: Publication Only
Background
Background: Eltrombopag is a thrombopoietin (TPO) nonpeptide mimetic that has been shown to raise the platelet count in both continued long-term administration and in a repeated short-term administration in chronic immune thrombocytopenia (ITP). However, information dealing with the concomitant use of eltrombopag and dexamethasone in patients with chronic ITP are lacking.
Aims
Aim: The purpose of this study was to assess the efficacy of eltrombopag in combination with dexamethasone in a consecutive, unselected series of patients with chronic ITP followed up in a single institution in the period May 2014- December 2015.
Methods
Methods: Eleven patients (6 F/ 5 M) with median age 53 years (range, 29-70) who had at least a 6-month history of ITP (median 26 months; range 6-220 months) were considered eligible for the present analysis. All patients had a platelet count lower than 30 × 109/Land bleeding manifestations were present in 7 out of 11. No patient had an active infection, drug-associated thrombocytopenia, positive serology for HIV, hepatitis B or hepatitis C, malignant diseases or was pregnant. After initiating eltrombopag (50 mg once a day)doses were adjusted to achieve and maintain a platelet count ≥ 50,000/μl as necessary to reduce the risk for bleeding. Eltrombopag dose did not exceed 75 mg/day. Dexamethasone 40 mg/day was given for 4 days every 28 days. Patients with glucose intolerance or diabetes needing therapy received an mitigated dose of dexamethasone (20 mg/day). Response and complete response (CR) were defined as an increase in platelets ≥30 <100 × 109/L and ≥100 × 109/L, respectively.
Results
Results:All patients achieved a responseduring the treatment while a CR was obtained in 10 of 11 patients. Maximum response was reached after a median time of 12 weeks (range, 3-39). After a median follow-up time of 29 weeks (range, 8-89) response was still maintained in all patients while 5 patients lost CR. Four patients who lost CR were receiving maintainence therapy with eltrombopag (25 mg/day from a period ranging between 2 and 14 weeks). In the fifth patient CR was lost 7 weeks after treatment was interrupted because of pregnancy.Finally, the median probability of maintaining CR-free survival was 42 weeks (Figure 1).
Conclusion
ConclusionsResults of this study although limited by the small sample sizeand the lack of a comparative randomized design suggest that dexamethasone in combination with a thrombopoiesis stimulating agent led to a long-lasting remission of ITP. High-dose dexamethasone may modify the immunological milieu, resulting in an enhanced response to the thrombopoietin receptor agonist.
Session topic: E-poster
Type: Publication Only
Background
Background: Eltrombopag is a thrombopoietin (TPO) nonpeptide mimetic that has been shown to raise the platelet count in both continued long-term administration and in a repeated short-term administration in chronic immune thrombocytopenia (ITP). However, information dealing with the concomitant use of eltrombopag and dexamethasone in patients with chronic ITP are lacking.
Aims
Aim: The purpose of this study was to assess the efficacy of eltrombopag in combination with dexamethasone in a consecutive, unselected series of patients with chronic ITP followed up in a single institution in the period May 2014- December 2015.
Methods
Methods: Eleven patients (6 F/ 5 M) with median age 53 years (range, 29-70) who had at least a 6-month history of ITP (median 26 months; range 6-220 months) were considered eligible for the present analysis. All patients had a platelet count lower than 30 × 109/Land bleeding manifestations were present in 7 out of 11. No patient had an active infection, drug-associated thrombocytopenia, positive serology for HIV, hepatitis B or hepatitis C, malignant diseases or was pregnant. After initiating eltrombopag (50 mg once a day)doses were adjusted to achieve and maintain a platelet count ≥ 50,000/μl as necessary to reduce the risk for bleeding. Eltrombopag dose did not exceed 75 mg/day. Dexamethasone 40 mg/day was given for 4 days every 28 days. Patients with glucose intolerance or diabetes needing therapy received an mitigated dose of dexamethasone (20 mg/day). Response and complete response (CR) were defined as an increase in platelets ≥30 <100 × 109/L and ≥100 × 109/L, respectively.
Results
Results:All patients achieved a responseduring the treatment while a CR was obtained in 10 of 11 patients. Maximum response was reached after a median time of 12 weeks (range, 3-39). After a median follow-up time of 29 weeks (range, 8-89) response was still maintained in all patients while 5 patients lost CR. Four patients who lost CR were receiving maintainence therapy with eltrombopag (25 mg/day from a period ranging between 2 and 14 weeks). In the fifth patient CR was lost 7 weeks after treatment was interrupted because of pregnancy.Finally, the median probability of maintaining CR-free survival was 42 weeks (Figure 1).
Conclusion
ConclusionsResults of this study although limited by the small sample sizeand the lack of a comparative randomized design suggest that dexamethasone in combination with a thrombopoiesis stimulating agent led to a long-lasting remission of ITP. High-dose dexamethasone may modify the immunological milieu, resulting in an enhanced response to the thrombopoietin receptor agonist.
Session topic: E-poster
Abstract: PB2090
Type: Publication Only
Background
Background: Eltrombopag is a thrombopoietin (TPO) nonpeptide mimetic that has been shown to raise the platelet count in both continued long-term administration and in a repeated short-term administration in chronic immune thrombocytopenia (ITP). However, information dealing with the concomitant use of eltrombopag and dexamethasone in patients with chronic ITP are lacking.
Aims
Aim: The purpose of this study was to assess the efficacy of eltrombopag in combination with dexamethasone in a consecutive, unselected series of patients with chronic ITP followed up in a single institution in the period May 2014- December 2015.
Methods
Methods: Eleven patients (6 F/ 5 M) with median age 53 years (range, 29-70) who had at least a 6-month history of ITP (median 26 months; range 6-220 months) were considered eligible for the present analysis. All patients had a platelet count lower than 30 × 109/Land bleeding manifestations were present in 7 out of 11. No patient had an active infection, drug-associated thrombocytopenia, positive serology for HIV, hepatitis B or hepatitis C, malignant diseases or was pregnant. After initiating eltrombopag (50 mg once a day)doses were adjusted to achieve and maintain a platelet count ≥ 50,000/μl as necessary to reduce the risk for bleeding. Eltrombopag dose did not exceed 75 mg/day. Dexamethasone 40 mg/day was given for 4 days every 28 days. Patients with glucose intolerance or diabetes needing therapy received an mitigated dose of dexamethasone (20 mg/day). Response and complete response (CR) were defined as an increase in platelets ≥30 <100 × 109/L and ≥100 × 109/L, respectively.
Results
Results:All patients achieved a responseduring the treatment while a CR was obtained in 10 of 11 patients. Maximum response was reached after a median time of 12 weeks (range, 3-39). After a median follow-up time of 29 weeks (range, 8-89) response was still maintained in all patients while 5 patients lost CR. Four patients who lost CR were receiving maintainence therapy with eltrombopag (25 mg/day from a period ranging between 2 and 14 weeks). In the fifth patient CR was lost 7 weeks after treatment was interrupted because of pregnancy.Finally, the median probability of maintaining CR-free survival was 42 weeks (Figure 1).
Conclusion
ConclusionsResults of this study although limited by the small sample sizeand the lack of a comparative randomized design suggest that dexamethasone in combination with a thrombopoiesis stimulating agent led to a long-lasting remission of ITP. High-dose dexamethasone may modify the immunological milieu, resulting in an enhanced response to the thrombopoietin receptor agonist.
Session topic: E-poster
Type: Publication Only
Background
Background: Eltrombopag is a thrombopoietin (TPO) nonpeptide mimetic that has been shown to raise the platelet count in both continued long-term administration and in a repeated short-term administration in chronic immune thrombocytopenia (ITP). However, information dealing with the concomitant use of eltrombopag and dexamethasone in patients with chronic ITP are lacking.
Aims
Aim: The purpose of this study was to assess the efficacy of eltrombopag in combination with dexamethasone in a consecutive, unselected series of patients with chronic ITP followed up in a single institution in the period May 2014- December 2015.
Methods
Methods: Eleven patients (6 F/ 5 M) with median age 53 years (range, 29-70) who had at least a 6-month history of ITP (median 26 months; range 6-220 months) were considered eligible for the present analysis. All patients had a platelet count lower than 30 × 109/Land bleeding manifestations were present in 7 out of 11. No patient had an active infection, drug-associated thrombocytopenia, positive serology for HIV, hepatitis B or hepatitis C, malignant diseases or was pregnant. After initiating eltrombopag (50 mg once a day)doses were adjusted to achieve and maintain a platelet count ≥ 50,000/μl as necessary to reduce the risk for bleeding. Eltrombopag dose did not exceed 75 mg/day. Dexamethasone 40 mg/day was given for 4 days every 28 days. Patients with glucose intolerance or diabetes needing therapy received an mitigated dose of dexamethasone (20 mg/day). Response and complete response (CR) were defined as an increase in platelets ≥30 <100 × 109/L and ≥100 × 109/L, respectively.
Results
Results:All patients achieved a responseduring the treatment while a CR was obtained in 10 of 11 patients. Maximum response was reached after a median time of 12 weeks (range, 3-39). After a median follow-up time of 29 weeks (range, 8-89) response was still maintained in all patients while 5 patients lost CR. Four patients who lost CR were receiving maintainence therapy with eltrombopag (25 mg/day from a period ranging between 2 and 14 weeks). In the fifth patient CR was lost 7 weeks after treatment was interrupted because of pregnancy.Finally, the median probability of maintaining CR-free survival was 42 weeks (Figure 1).
Conclusion
ConclusionsResults of this study although limited by the small sample sizeand the lack of a comparative randomized design suggest that dexamethasone in combination with a thrombopoiesis stimulating agent led to a long-lasting remission of ITP. High-dose dexamethasone may modify the immunological milieu, resulting in an enhanced response to the thrombopoietin receptor agonist.
Session topic: E-poster
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