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SWITCH OF TPO-MIMETICS IN PATIENTS WITH CHRONIC IMMUNE THROMBOCYTOPENIA:FLORENCE MONOCENTRIC EXPERIENCE.
Author(s):
Caterina Biagiotti
,
Caterina Biagiotti
Affiliations:
Hematology,Careggi Hospital,Florence,Italy
Valentina Carrai
,
Valentina Carrai
Affiliations:
Hematology,Careggi Hospital,Florence,Italy
Francesca Bacchiarri
,
Francesca Bacchiarri
Affiliations:
Hematology,Careggi Hospital,Florence,Italy
Alberto Bosi
Alberto Bosi
Affiliations:
Hematology,Careggi Hospital,Florence,Italy
(Abstract release date: 05/18/17) EHA Library. Biagiotti C. 05/18/17; 182829; PB2115
Dr. Caterina Biagiotti
Dr. Caterina Biagiotti
Contributions
PDF Abstract
Abstract

Abstract: PB2115

Type: Publication Only

Background

Primary immune thrombocytopenia (ITP) is an immune-mediated condition characterized by isolated thrombocytopenia, with peripheral blood platelet count of <100.000/μl in the absence of an identifiable underlying cause of thrombocytopenia. Clinical studies in patients with ITP demonstrated that thrombopoietin (TPO) mimetics increase platelet production and can outpace platelet destruction.

Aims
We evalueted patients treated with both TPO-mimetics.

Methods

From November 2008 and February 2017, 65 patients were treated with TPO-mimetics with a median follow up of 29 months (1-96): 39 patients underwent therapy with Romiplostim and 26 to Eltrombopag. In our study we evaluated 18 patients who received both therapies: among patients treated at first with Romiplostim, 10 patients (9F; 1 M) switched to Eltrombopag and 8 patients (3 M; 5 F) switched from Eltrombopag to Romiplostim. In the group of 10 patients treated at first with Romiplostim, 5 patients started Eltrombopag because were no responders, 3 for loss of response and 2 patients because of adverse events. In the group of 8 patients at first treated with Eltrombopag, 4 patients didn’t obtain any response with Eltrombopag and switched to Romiplostim, 1 patient underwent to Romiplostim for loss of response and 3 patients because of adverse events.

Results

Among patients switched from Romiplostim to Eltrombopag, 2 achieved complete response, 4 response and 4 were no responders; among patients switched from Eltrombopag to Romiplostim, 4 obtained complete response, 3 response, 1 was no responder.

Conclusion
Romiplostim and Eltrombopag stimulate the TPO-R but have different mechanisms of action, therefore, in our limited experience switching from one thrombopoietic receptoragonist to the other could be beneficial in clinical practice for patients with severe chronic immune thrombocytopenia who failed to respond or experienced adverse events to the first treatment.

Session topic: 32. Platelets disorders

Abstract: PB2115

Type: Publication Only

Background

Primary immune thrombocytopenia (ITP) is an immune-mediated condition characterized by isolated thrombocytopenia, with peripheral blood platelet count of <100.000/μl in the absence of an identifiable underlying cause of thrombocytopenia. Clinical studies in patients with ITP demonstrated that thrombopoietin (TPO) mimetics increase platelet production and can outpace platelet destruction.

Aims
We evalueted patients treated with both TPO-mimetics.

Methods

From November 2008 and February 2017, 65 patients were treated with TPO-mimetics with a median follow up of 29 months (1-96): 39 patients underwent therapy with Romiplostim and 26 to Eltrombopag. In our study we evaluated 18 patients who received both therapies: among patients treated at first with Romiplostim, 10 patients (9F; 1 M) switched to Eltrombopag and 8 patients (3 M; 5 F) switched from Eltrombopag to Romiplostim. In the group of 10 patients treated at first with Romiplostim, 5 patients started Eltrombopag because were no responders, 3 for loss of response and 2 patients because of adverse events. In the group of 8 patients at first treated with Eltrombopag, 4 patients didn’t obtain any response with Eltrombopag and switched to Romiplostim, 1 patient underwent to Romiplostim for loss of response and 3 patients because of adverse events.

Results

Among patients switched from Romiplostim to Eltrombopag, 2 achieved complete response, 4 response and 4 were no responders; among patients switched from Eltrombopag to Romiplostim, 4 obtained complete response, 3 response, 1 was no responder.

Conclusion
Romiplostim and Eltrombopag stimulate the TPO-R but have different mechanisms of action, therefore, in our limited experience switching from one thrombopoietic receptoragonist to the other could be beneficial in clinical practice for patients with severe chronic immune thrombocytopenia who failed to respond or experienced adverse events to the first treatment.

Session topic: 32. Platelets disorders

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