Abstract

INTRODUCTION

Immune thrombocytopenia (ITP), which is also used as idiopathic thrombocytopenic purpura, is a clinical condition that can progress with severe thrombocytopenia and life-threatening bleeding. Thrombopoetin receptor analogues such as rompilostim and eltrombopag, which have been used in the last 10 years, are new agents with proven efficacy. Our aim in this study is to evaluate the efficacy and toxicity of eltrombopag in steroid resistant ITP patients with real life data.

METHODS

This study was conducted with a retrospective evaluation of patients treated with a diagnosis of ITP between January 2012 and September 2020. Patients under 18 years of age and using eltrombopag for non-ITP indications were excluded from the study.

RESULTS

The median age of 31 patients included in our study was 60 (25-87). Eighteen (58.0%) of these patients were women. The number of patients with at least one comorbidity was 19 (61.2%). All of the patients had received glucocorticosteroid treatment in the first line for ITP treatment. Splenectomy was applied as a second line treatment to 16 (51.6%) of these patients who were resistant to steroid treatment. Before eltrombopag, the median platelet value was 11x109/L (1x109/L - 46x109/L), while 24 (77.4%) patients responded to the treatment. In patients with a response, the median day 17 (day 3-57) thrombocyte count increased over 50x109/L. Sixteen of these patients (51.6%) had a response of 50 mg/day, seven (22.5%) 25 mg/day, and one (3.2%) patient 75 mg/day eltrombopag treatment. Two (6.4%) patients had an increase in grade 1 liver function tests. There was no patient who could not continue or interrupted the treatment due to side effects.

DISCUSSION AND CONCLUSION

It has been observed that eltrombopag treatment is an effective and safe option even in the group of patients who have previously received multiple-line therapy in ITP treatment.