Successful discontinuation of eltrombopag after complete remission in patients with primary immune thrombocytopenia

Autores de IIS La Fe

• Isidro Jarque Ramos

  Autor

• Maria Eva Mingot Castellano

  Autor

• Monica Martin Salces

  Autor

• Rebeca Jimenez Carreño

  Autor

• Jose Manuel Maroñas Andrade

  Autor

• Rosario Alonso Estellés

  Autor

• Cristóbal Eduardo Aguilar Gallardo

  Autor

Participantes ajenos a IIS La Fe

• González-López TJ
• Pascual C
• Álvarez-Román MT
• Fernández-Fuertes F
• Sánchez-González B
• Caparrós I
• Hernández-Rivas JA
• Solán L
• Beneit P
• Bernat S
• Cortés M
• Cortti MJ
• Pérez-Crespo S
• Gómez-Núñez M
• Olivera PE
• Pérez-Rus G
• Martínez-Robles V
• Fernández-Rodríguez A
• Arratibel MC
• Perera M
• Fernández-Miñano C
• Fuertes-Palacio MA
• Vázquez-Paganini JA
• Gutierrez-Jomarrón I
• Valcarce I
• de Cabo E
• Sainz A
• Fisac R
• Paz Martínez-Badas M
• Peñarrubia MJ
• Calbacho M
• de Cos C
• González-Silva M
• Coria E
• Alonso A
• Casaus A
• Luaña A
• Galán P
• Fernández-Canal C
• Garcia-Frade J
• González-Porras JR

Grupos

• Hematología y Hemoterapia

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

Abstract

Eltrombopag is effective and safe in immune thrombocytopenia (ITP). Some patients may sustain their platelet response when treatment is withdrawn but the frequency of this phenomenon is unknown. We retrospectively evaluated 260 adult primary ITP patients (165 women and 95 men; median age, 62 years) treated with eltrombopag after a median time from diagnosis of 24 months. Among the 201 patients who achieved a complete remission (platelet count >100 x 10(9)/l), eltrombopag was discontinued in 80 patients. Reasons for eltrombopag discontinuation were: persistent response despite a reduction in dose over time (n = 33), platelet count >400 x 10(9)/l (n = 29), patient's request (n = 5), elevated aspartate aminotransferase (n = 3), diarrhea (n = 3), thrombosis (n = 3), and other reasons (n = 4). Of the 49 evaluable patients, 26 patients showed sustained response after discontinuing eltrombopag without additional ITP therapy, with a median follow-up of 9 (range, 6-25) months. These patients were characterized by a median time since ITP diagnosis of 46.5 months, with 4/26 having ITP<1 year. Eleven patients were male and their median age was 59 years. They received a median of 4 previous treatment lines and 42% were splenectomized. No predictive factors of sustained response after eltrombopag withdrawal were identified. Platelet response following eltrombopag cessation may be sustained in an important percentage of adult primary ITP patients who achieved CR with eltrombopag. However, reliable markers for predicting which patients will have this response are needed. Am. J. Hematol. 90:E40-E43, 2015. (c) 2014 Wiley Periodicals, Inc.