Romiplostim therapy as a second‐line treatment before splenectomy for refractory immune thrombocytopenia in a cirrhotic patient with iatrogenic Cushing syndrome secondary to corticosteroids

Taltavull, Teresa Casanovas; Peña-Cala, Maria Carmen

doi:10.1002/ccr3.667

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…[ 9 ] Additionally, corticosteroids, for example prednisone, are also used for treating thrombocytopenia but likewise toxic. [ 13 ] Then it is urgent to explore safety therapeutic strategies for CIT, such as dietary supplement.…”

Section: Introductionmentioning

confidence: 99%

The Protective Effect of Sweet Potato Root Tuber on Chemotherapy‐Induced Thrombocytopenia

Yan

Liu

et al. 2022

Molecular Nutrition Food Res

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Scope Sweet potato (Ipomoea batatas L.) is one of the leading crops worldwide, containing high nutritional components such as fiber and polyphenols. Root tuber of Simon 1 (SIMON), a cultivar of sweet potato, is a folk food in China with a hemostasis function but lacking experimental data support. Methods and results Now the protective effect of SIMON on chemotherapy‐induced thrombocytopenia (CIT), a serious complication of cancer treatment, is investigated for the first time by a CIT mouse model induced by intraperitoneal injection of carboplatin. As a result, SIMON raises the number of peripheral platelets, white blood cells, and bone marrow nucleated cells in CIT mice significantly. Besides, carboplatin‐induced atrophy of the thymus, spleen, and disordered metabolism of the inflammatory immune system and glycerophospholipids are also reversed by SIMON. Phytochemical analysis of SIMON indicates 16 compounds including eight phenolic derivatives, which might be associated with its anti‐CIT bioactivity. Conclusion Sweet potato (SIMON) may be an efficient function food in the prevention of bleeding disorders.

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Section: Introductionmentioning

confidence: 99%

The Protective Effect of Sweet Potato Root Tuber on Chemotherapy‐Induced Thrombocytopenia

Yan

Liu

et al. 2022

Molecular Nutrition Food Res

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Prednisone

2017

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Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease

Khemichian

Terrault

2020

Semin Thromb Hemost

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Thrombocytopenia is one of the most common hematologic complications in cirrhosis. Despite limited data linking platelet count and bleeding risk in patients with cirrhosis, the use of platelets transfusions for invasive procedures has been a common practice. Recently, thrombopoietin (TPO) receptor agonists have been approved for use in patients with chronic liver disease (CLD) undergoing invasive procedures. The aim of this study was to review current literature on bleeding risk in patients with cirrhosis and the use of platelet transfusions and TPO receptor agonists in the context of invasive procedures. PubMed search was conducted to find articles relating to cirrhosis, thrombocytopenia, and new novel treatments for this condition. Search terms included CLD, cirrhosis, thrombocytopenia, bleeding, thrombosis, coagulopathy, hemostasis, and TPO receptor agonists. Romiplostim, eltrombopag, avatrombopag, and lusutrombopag are approved TPO receptor agonists, with avatrombopag and lusutrombopag specifically approved for use in patients with CLD undergoing invasive procedures. In patients with platelet counts < 50,000/mm3, avatrombopag and lusutrombopag increased the platelet counts above this threshold in the majority of treated patients and reduced the frequency of platelet transfusions. At the approved doses, incidence of thrombosis was not increased and therapies were well tolerated. Studies were not powered to assess whether risk of bleeding complications was reduced and the fundamental question of whether correction of thrombocytopenia is warranted in patients undergoing invasive procedures remains unanswered. The use of TPO receptor agonists has resulted in less requirement for platelet transfusions. In patients with cirrhosis undergoing invasive procedures for whom platelet transfusion is planned, TPO receptor agonists are an alternative and avoid the risks associated with transfusions. However, there is need for a thoughtful approach to manage bleeding risk in patients with cirrhosis undergoing procedures, with the consideration of a comprehensive hemostatic profile, the severity of portal hypertension, and the complexity of the invasive procedure to guide decisions regarding transfusions or use of TPO receptor agonists.

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Romiplostim therapy as a second‐line treatment before splenectomy for refractory immune thrombocytopenia in a cirrhotic patient with iatrogenic Cushing syndrome secondary to corticosteroids

Cited by 3 publications

References 16 publications

The Protective Effect of Sweet Potato Root Tuber on Chemotherapy‐Induced Thrombocytopenia

The Protective Effect of Sweet Potato Root Tuber on Chemotherapy‐Induced Thrombocytopenia

Prednisone

Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease

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