Onkológia S3/2022

Experience with the treatment of chronic immune thrombocytopenia

Introduction: Immune thrombocytopenia (ITP) is an acquired disease characterized by reduced platelet counts and increased bleeding risk. It results from autoimmune destruction of platelets due to the formation of antiplatelet autoantibodies and decreased platelet production arising from defective megakaryopoiesis. The primary goal of therapy for patients with chronic ITP is to keep the risk of bleeding to a minimum by increasing the platelet count to a safe level while minimizing treatment-related toxicities. Case report: The case of a 50-year-old patient with ITP associated with cutaneous and mucosal hemorrhagic manifestations is presented. After treatment with corticosteroids, which did not lead to an increase in platelet counts and was associated with side effects, treatment with eltrombopag was started. In this case, the number of platelets stabilized and after their temporary reduction in the number after omitting treatment for surgery, their number returned to the original stable state. Conclusion: Our case report confirmed the long-term persistence of stable platelet counts during eltrombopag treatment without side effects and without thrombotic manifestations. The bleeding symptoms disappeared, and the patient’s quality of life improved with good treatment tolerance.

Keywords: immune thrombocytopenia, bleeding, eltrombopag, surgery