Retrospective analysis of different regimens for Chinese adults with severe newly diagnosed immune thrombocytopenia

Wang, Xiaoyue; Xu, Yan; Gui, Weiwei; Feng, Hui; Liao, Hui

doi:10.1007/s10238-020-00630-7

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…In contrast, we did not detect any anti‐TPO antibodies in rhTPO‐treated patients, which might be related to the simultaneous administration of HD‐DXM. Other side effects of rhTPO reported in previous studies, 17,48 such as fever and erythra, could also be alleviated by short‐term pulsed HD‐DXM. So, rhTPO was also associated with the occurrence of fatigue, and the reported incidence was about 1.69% ‐3.2% 17,40,49 .…”

Section: Discussionmentioning

confidence: 73%

High‐dose dexamethasone plus recombinant human thrombopoietin vs high‐dose dexamethasone alone as frontline treatment for newly diagnosed adult primary immune thrombocytopenia: A prospective, multicenter, randomized trial

Wang

Hou

et al. 2020

American J Hematol

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Section: Discussionmentioning

confidence: 73%

High‐dose dexamethasone plus recombinant human thrombopoietin vs high‐dose dexamethasone alone as frontline treatment for newly diagnosed adult primary immune thrombocytopenia: A prospective, multicenter, randomized trial

Wang

Hou

et al. 2020

American J Hematol

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“…TPO is a thrombopoietic growth factor produced by the liver that expressly regulates the release of platelets. Studies have found that recombinant human thrombopoietin (rhTPO) can reduce platelet and red blood cell transfusions in IRH patients (12,22).…”

Section: Discussionmentioning

confidence: 99%

“…Atorvastatin can also improve platelet function by regulating the function of EPCs in patients with immune thrombocytopenia (3). Recombinant human thrombopoietin (TPO) can improve the short-term efficacy of IRH patients and reduce the amount of platelet and erythrocyte infusion (10)(11)(12). Currently, there is no relevant report on whether the bone marrow EPCs (BM EPCs) in IRH patients are damaged, and whether atorvastatin can improve the function of BM EPCs in IRH patients.…”

Section: Introductionmentioning

confidence: 99%

Atorvastatin improves bone marrow endothelial progenitor cell function from patients with immune-related hemocytopenia

Qian¹,

Shen

Yan³

et al. 2021

Ann Transl Med

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Background: Immune-related hemocytopenia (IRH) is a type of autoimmune disease that targets bone marrow hematopoietic cells. This study investigated the influence of atorvastatin on the functional aspects of bone marrow endothelial progenitor cells (BM EPCs) in IRH patients. Methods: BM EPCs were isolated from 15 patients with IRH and 20 normal controls. The isolated BM EPCs were characterized by flow cytometry. Cell counting kit-8, flow cytometry, and Transwell migration assays were used to determine the proliferation, apoptosis, and migration of BM EPCs, respectively. Protein levels were determined by western blot assay. Results: The BM EPCs isolated from IRH patients showed reduced proliferation, increased apoptosis, and attenuated migratory ability compared to those from normal controls. Western blot analysis showed that the protein level of p-p38 was significantly increased, while that of Phosphorylated protein kinase B (p-AKT) was significantly decreased in the BM EPCs from IRH patients, compared to BM EPCs from healthy subjects. Cell proliferation and migration were significantly enhanced by atorvastatin, recombinant human thrombopoietin, and SB20358 compared to the untreated BM EPCs from IRH patients. Atorvastatin, Recombinant human thrombopoietin (TPO), and SB20358 treatment significantly suppressed the protein levels of p-p38 protein, but increased those of p-AKT in BM EPCS from IRH patients. Conclusions: In summary, atorvastatin increases the number and function of BM EPCs in IRH patients by regulating the p38 and AKT signaling pathways.

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“…CR was characterized by the absence of bleeding and an increase in the platelets count to above 100 × 10 9 /L after one month of the treatment. SR was defined as achieving CR or partial response (PR) until the end of the study with a 2-fold upsurge from starting point [ 62 , 63 ]. PR was represented as PLTs count ≥ 30 × 10 9 /L after one month following therapy, and no response (NR) was defined as platelets < 30 × 10 9 /L or bleeding [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

The Outcomes and Adverse Drug Patterns of Immunomodulators and Thrombopoietin Receptor Agonists in Primary Immune Thrombocytopenia Egyptian Patients with Hemorrhage Comorbidity

et al. 2023

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Immune thrombocytopenia (ITP) treatment has evolved recently. However, none of the treatments have only benefits without drawbacks. This study aimed to compare the clinical outcomes and adverse drug patterns of Eltrombopag, Romiplostim, Prednisolone + Azathioprine, High Dose-dexamethasone (HD-DXM) (control group), and Rituximab in primary ITP Egyptian patients. All patients were initiated with corticosteroids, HD-DXM, as a first-line treatment for the first month immediately following diagnosis. Four hundred sixty-seven ITP patients were randomly assigned to five groups. The outcome measures were judged at baseline, at the end of treatment (6 months), and after an additional 6-month free treatment period. The follow-up period for which relapse is noted was 6 months after the end of treatment. Eltrombopag and Romiplostim resulted in a significantly higher incidence of sustained response than Rituximab, HD-DXM, and Prednisolone + Azathioprine (55.2% and 50.6% vs. 29.2%, 29.1%, and 18%, respectively; p-value < 0.001). More patients on immunomodulators (Prednisolone+ Azathioprine, HD-DXM, and Rituximab) relapsed than those on Romiplostim and Eltrombopag (81.9%, 70.8%, and 70.7% vs. 49.3%, and 44.7%, respectively; p-value < 0.01). We also describe 23 reports of pulmonary hypertension with Prednisolone+ Azathioprine and 13 reports with HD-DXM. The thrombotic events occurred in 16.6% and 13% of patients who received Eltrombopag and Romiplostim treatment, respectively. Most patients had at least one or two risk factors (92.8% of cases). Corticosteroids are effective first-line therapy in primary ITP patients. However, relapse is frequent. Eltrombopag and Romiplostim are safer and more effective than Prednisolone, HD-DXM, and Rituximab. They might be reasonable beneficial options after a one-month HD-DXM regimen.

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Retrospective analysis of different regimens for Chinese adults with severe newly diagnosed immune thrombocytopenia

Cited by 7 publications

References 22 publications

High‐dose dexamethasone plus recombinant human thrombopoietin vs high‐dose dexamethasone alone as frontline treatment for newly diagnosed adult primary immune thrombocytopenia: A prospective, multicenter, randomized trial

High‐dose dexamethasone plus recombinant human thrombopoietin vs high‐dose dexamethasone alone as frontline treatment for newly diagnosed adult primary immune thrombocytopenia: A prospective, multicenter, randomized trial

Atorvastatin improves bone marrow endothelial progenitor cell function from patients with immune-related hemocytopenia

The Outcomes and Adverse Drug Patterns of Immunomodulators and Thrombopoietin Receptor Agonists in Primary Immune Thrombocytopenia Egyptian Patients with Hemorrhage Comorbidity

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