ISSN 2564-7784 | E-ISSN 2564-7040
Case Report
Use of eltrombopag in patients with platelet engraftment failure following second allogeneic peripheral stem cell transplantation
1 Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey  
2 Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey  
3 Department of Hematology, Gaziantep University School of Medicine, Gaziantep, Turkey; Bone Marrow Transplantation Centre, Gaziantep University School of Medicine, Gaziantep, Turkey.  
Eur J Ther ; : -
DOI: 10.5152/EurJTher.2017.234
Key Words: Allogeneic peripheral stem cell transplantation, Eltrombopag, prolonged thrombocytopenia
Abstract

 

Thrombocytopenia after peripheral stem cell transplantation (PSCT) is associated with morbidity and mortality. Eltrombopag, a thrombopoietin receptor agonist is successfully used primarily in the treatment of chronic idiopathic thrombocytopenic purpura and other thrombocytopenias associated with aplastic anemia and myelodysplastic syndrome. Recently, the use of Eltrombopag in the treatment of thrombocytopenia after allogeneic PSCT is promising. The use of eltrombopag in 3 patients with hematologic malignancy who experienced graft failure after the first PSCT and developed platelet engraftment failure following the second bone marrow (BM) transplantation was presented retrospectively. Patients were 2 males, 1 female, with the mean age of 52 (45-57) years. The diagnoses were acute myeloid leukemia, non-hodgkin lymphoma, acute lymphocytic leukemia. All patients underwent allogeneic PSCT with myeloablative regimen. Platelet engraftment failure was detected during the follow-up of the patients. Acute grade 3 skin graft versus host disease developed in non-hodgkin lymphoma (NHL) patient. Mycophenolate-mofetil, cyclosporin-A, steroid-based immunosuppression therapy; patients completly responded in the first week of treatment. However, thrombocytopenia persisted. None of the patients had any viral infection or relapse. BM biopsies of patients were hypocellular, the number of megakaryocytes decreased. Eltrombopag was initiated in 3 patients 110 days (60-144) after transplantation on average. Responses were obtained in all of the patients; the platelet value was ≥ 30 × 103/µL (30.000-247.000). The mean duration of response was 27 days (20-35). Although the need to work more is the use of the Eltrombopag, it can be used safely and effectively in patients with platelet engraftment failure after PSCT.

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