Clonal hematopoiesis in primary immune thrombocytopenia

Wang, Yanming; Yu, Tengbo; Dong, Qiaofeng; Liu, Shuang; Yu, Yonghua; Zhao, Hanxi; Ma, Ji; Lin, Dong; Wang, Liang; Ma, Daoxin; Zhao, Yajing; Hou, Yu; Liu, Xin‐guang; Peng, Jun; Hou, Ming

doi:10.1038/s41408-022-00641-5

Cited by 2 publications

(1 citation statement)

References 13 publications

(12 reference statements)

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“…DAT is suitable for ITP patients with clinical or laboratory evidence of hemolysis. Because of the substantial reduction in the cost of next-generation sequencing, genomic assays, such as whole-exome sequencing (WES), whole-genome sequencing, or targeted gene sequencing, may provide valuable information for multirefractory patients or cases who will undergo splenectomy to exclude MDS, bone marrow failure syndrome, and inherited thrombocytopenias [ 77 , 78 ]. Laboratory tests in the differential diagnosis of ITP are summarized in Table 1 .…”

Section: Diagnosis and Prognosis Of Itpmentioning

confidence: 99%

How we treat primary immune thrombocytopenia in adults

Liu

Hou

2023

J Hematol Oncol

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Primary immune thrombocytopenia (ITP) is an immune-mediated bleeding disorder characterized by decreased platelet counts and an increased risk of bleeding. Multiple humoral and cellular immune abnormalities result in accelerated platelet destruction and suppressed platelet production in ITP. The diagnosis remains a clinical exclusion of other causes of thrombocytopenia. Treatment is not required except for patients with active bleeding, severe thrombocytopenia, or cases in need of invasive procedures. Corticosteroids, intravenous immunoglobulin, and anti-RhD immunoglobulin are the classical initial treatments for newly diagnosed ITP in adults, but these agents generally cannot induce a long-term response in most patients. Subsequent treatments for patients who fail the initial therapy include thrombopoietic agents, rituximab, fostamatinib, splenectomy, and several older immunosuppressive agents. Other potential therapeutic agents, such as inhibitors of Bruton’s tyrosine kinase and neonatal Fc receptor, are currently under clinical evaluation. An optimized treatment strategy should aim at elevating the platelet counts to a safety level with minimal toxicity and improving patient health-related quality of life, and always needs to be tailored to the patients and disease phases. In this review, we address the concepts of adult ITP diagnosis and management and provide a comprehensive overview of current therapeutic strategies under general and specific situations.

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Section: Diagnosis and Prognosis Of Itpmentioning

confidence: 99%

How we treat primary immune thrombocytopenia in adults

Liu

Hou

2023

J Hematol Oncol

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The impact of age and number of mutations on the size of clonal hematopoiesis

Wang,

Zhang,

et al. 2024

Proc. Natl. Acad. Sci. U.S.A.

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Clonal hematopoiesis (CH) represents the clonal expansion of hematopoietic stem cells and their progeny driven by somatic mutations. Accurate risk assessment of CH is critical for disease prevention and clinical decision-making. The size of CH has been showed to associate with higher disease risk, yet, factors influencing the size of CH are unknown. In addition, the characteristics of CH in long-lived individuals are not well documented. Here, we report an in-depth analysis of CH in longevous (≥90 y old) and common (60~89 y old) elderly groups. Utilizing targeted deep sequencing, we found that the development of CH is closely related to age and the expression of aging biomarkers. The longevous elderly group exhibited a significantly higher incidence of CH and significantly higher frequency of TET2 and ASXL1 mutations, suggesting that certain CH could be beneficial to prolong life. Intriguingly, the size of CH neither correlates significantly to age, in the range of 60 to 110 y old, nor to the expression of aging biomarkers. Instead, we identified a strong correlation between large CH size and the number of mutations per individual. These findings provide a risk assessment biomarker for CH and also suggest that the evolution of the CH is influenced by factor(s) in addition to age.

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Clonal hematopoiesis in primary immune thrombocytopenia

Cited by 2 publications

References 13 publications

How we treat primary immune thrombocytopenia in adults

How we treat primary immune thrombocytopenia in adults

The impact of age and number of mutations on the size of clonal hematopoiesis

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