Tomás José González-López1,2, Blanca Sánchez-González3, Isidro Jarque4, Silvia Bernat5, Fernando Fernández-Fuertes6, Isabel Caparrós7, Inmaculada Soto8, Angeles Fernández-Rodríguez8, Estefanía Bolaños9, Gloria Pérez-Rus10, Cristina Pascual10, José Angel Hernández-Rivas11, Elsa López-Ansoar12, Marta Gómez-Nuñez13, Violeta Martínez-Robles14, Pavel Olivera15, Maria Yera Cobo16, María Jesús Peñarrubia17, Carmen Fernández-Miñano18, Erik de Cabo19, María Paz Martínez Badas20, Germán Perdomo2, Luis Javier García-Frade21. 1. Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain. 2. Department of Health Sciences, University of Burgos, Burgos, Spain. 3. Department of Hematology, Hospital del Mar, Barcelona, Spain. 4. Department of Hematology, Hospital Universitario La Fé, Valencia, Spain. 5. Department of Hematology, Hospital de La Plana, Castellón, Spain. 6. Department of Hematology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. 7. Department of Hematology, Hospital Clínico de Málaga, Málaga, Spain. 8. Department of Hematology, Hospital Universitario Central de Asturias, Oviedo (Asturias), Spain. 9. Department of Hematology, Hospital Universitario Clínico San Carlos, Madrid, Spain. 10. Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 11. Department of Hematology, Hospital Infanta Leonor, Madrid, Spain. 12. Department of Hematology, Complejo Hospitalario Universitario de Orense, Orense, Spain. 13. Department of Hematology, Hospital Parc Taulí, Sabadell (Barcelona), Spain. 14. Department of Hematology, Hospital de León, León, Spain. 15. Department of Hematology, Hospital Universitario Vall de Hebron, Barcelona, Spain. 16. Department of Hematology, Hospital Puerta del Mar, Cádiz, Spain. 17. Department of Hematology, Hospital Clínico de Valladolid, Valladolid, Spain. 18. Department of Hematology, Hospital Vega Baja, Orihuela (Alicante), Spain. 19. Department of Hematology, Hospital del Bierzo, Ponferrada (León), Spain. 20. Department of Hematology, Hospital de Avila, Avila, Spain. 21. Department of Hematology, Hospital Universitario Río Hortega, Valladolid, Spain.
Abstract
BACKGROUND: Eltrombopag is useful for immune thrombocytopenia (ITP). However, results of clinical trials may not accurately mirror clinical practice reality. Here we evaluated eltrombopag for primary and secondary ITP in our ≥65-year-old population. METHODS: A total of 106 primary ITP patients (16 with newly diagnosed ITP, 16 with persistent ITP, and 74 with chronic ITP) and 39 secondary ITP patients (20 with ITP secondary to immune disorders, 7 with ITP secondary to infectious diseases, and 12 with ITP secondary to lymphoproliferative disorders [LPD]) were retrospectively evaluated. RESULTS: Median age of our cohort was 76 (interquartile range, IQR, 70-81) years. 75.9% of patients yielded a platelet response including 66.2% complete responders. Median time to platelet response was 14 (IQR, 8-21) days. Median time on response was 320 (IQR, 147-526) days. Sixty-three adverse events (AEs), mainly grade 1-2, occurred. The most common were hepatobiliary laboratory abnormalities (HBLAs) and headaches. One transient ischemic attack in a newly diagnosed ITP and two self-limited pulmonary embolisms in secondary ITP were the only thrombotic events observed. CONCLUSION: Eltrombopag showed efficacy and safety in ITP patients aged ≥65 years with primary and secondary ITP. However, efficacy results in LPD-ITP were poor. A relatively high number of deaths were observed.
BACKGROUND:Eltrombopag is useful for immune thrombocytopenia (ITP). However, results of clinical trials may not accurately mirror clinical practice reality. Here we evaluated eltrombopag for primary and secondary ITP in our ≥65-year-old population. METHODS: A total of 106 primary ITPpatients (16 with newly diagnosed ITP, 16 with persistent ITP, and 74 with chronic ITP) and 39 secondary ITPpatients (20 with ITP secondary to immune disorders, 7 with ITP secondary to infectious diseases, and 12 with ITP secondary to lymphoproliferative disorders [LPD]) were retrospectively evaluated. RESULTS: Median age of our cohort was 76 (interquartile range, IQR, 70-81) years. 75.9% of patients yielded a platelet response including 66.2% complete responders. Median time to platelet response was 14 (IQR, 8-21) days. Median time on response was 320 (IQR, 147-526) days. Sixty-three adverse events (AEs), mainly grade 1-2, occurred. The most common were hepatobiliary laboratory abnormalities (HBLAs) and headaches. One transient ischemic attack in a newly diagnosed ITP and two self-limited pulmonary embolisms in secondary ITP were the only thrombotic events observed. CONCLUSION:Eltrombopag showed efficacy and safety in ITPpatients aged ≥65 years with primary and secondary ITP. However, efficacy results in LPD-ITP were poor. A relatively high number of deaths were observed.