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The association of lymphocyte phenotypes and outcomes after discontinuing eltrombopag in ITP
  • Satoko Oka,
  • Masaharu Nohgawa
Satoko Oka
Japanese Red Cross society Wakayama Medical Center
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Masaharu Nohgawa
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Abstract

Eltrombopag is a highly effective treatment for immune thrombocytopenia (ITP). Cases of durable remission after the discontinuation of eltrombopag in adult ITP have recently been reported; however, the frequency and mechanisms responsible for this phenomenon remain unknown. In the present study, we examined the phenotypes of lymphocytes in ITP to clarify whether they predict outcomes after the discontinuation of eltrombopag. We examined 56 adult newly diagnosed ITP patients treated with eltrombopag after a median time from diagnosis of 48 months. Among the 38 patients who achieved complete remission, eltrombopag was discontinued in 26. Among the 26 patients, 12 (46.2%) had an immediate relapse after discontinuing eltrombopag and 16 (53.8%) showed sustained response without additional ITP therapy, despite discontinuing eltrombopag, with a median follow-up of 52 months. No significant differences were observed in platelets, the median duration of eltrombopag, the absolute number of T, B, and NK cells at the initiation of eltrombopag between patients who sustained response and those who relapsed after discontinuing eltrombopag. However, the number of B and NK cells at the discontinuation of eltrombopag was higher in patients who sustained response than in those who relapsed (p=0.022 and p=0.012, respectively). The present results indicate that the absolute number of B (≥ 0.20 x 109/L) and NK (≥ 0.36 x 109/L) cells at the discontinuation of eltrombopag contributes to the prediction of outcomes.

Peer review status:ACCEPTED

10 Dec 2020Submitted to International Journal of Clinical Practice
10 Dec 2020Submission Checks Completed
10 Dec 2020Assigned to Editor
11 Dec 2020Reviewer(s) Assigned
02 Jan 2021Review(s) Completed, Editorial Evaluation Pending
08 Jan 20211st Revision Received
11 Jan 2021Submission Checks Completed
11 Jan 2021Assigned to Editor
11 Jan 2021Reviewer(s) Assigned
23 Jan 2021Review(s) Completed, Editorial Evaluation Pending
25 Jan 2021Editorial Decision: Accept