Onkológia S3/2022

Clinical benefit of long-time treatment with thrombopoietin-receptor agonists in patient with unresponsive immune thrombocytopenia

Introduction: Immune thrombocytopenia (ITP) is an autoimmune disease, characterized by an isolated platelet count < 100 x 109/l, level of it determines the bleeding risk. Aetiology of disease is not be in focus and diagnosis relies „per exclusionem“. Differentiation between ITP and secondary non-immune thrombocytopenia is crucial for choice of treatment (1). The therapy is focused on immune modulation of pathogenesis and increase platelet production in bone marrow. Thrombopoietin-receptor agonists (TPO-RA) represents an effective and prudent choice for the treatment of unresponsive ITP. Case: In the article we present a case report of an elderly patient with chronic unresponsive ITP, suffering this disease from adolescence. The case is an example of excellent efficacy of the thrombopoietin receptor agonist eltrombopag in maintaining long-term remission ITP, and significant increase in quality of life (HRQoL). Conclusion: Our experience confirms possibility of a favorable laboratory and clinical influence of unresponsive ITP using peroral TPO-RA eltrombopag. This treatment enabled the patient physical activity without any restrictions and ensures a long-term permanent condition without haemorrhagic diathesis.

Keywords: immune thrombocytopenia, thrombocytes, thrombopoietin-receptor agonists (TPO-RA), eltrombopag, bleeding, immune-modulation