title: Infection-related transient loss of response and other early side effects in chronic ITP during treatment with thrombopoietin mimetics.
abstract: BACKGROUND
  The new thrombopoietin mimetics (TM) romiplostim (Nplate®) and eltrombopag (Revolade®) have been demonstrated to increase platelet counts in the majority of patients with chronic autoimmune thrombocytopenia (ITP). Platelet counts in chronic ITP may fluctuate significantly due to infections, but it is unknown if this holds true in patients being treated with TM.
  
  
  METHODS
  13 adult patients with refractory chronic ITP were treated with the new TM. 10 patients were only treated with eltrombopag, 2 were initially treated with eltrombopag and subsequently switched to romiplostim, and 1 patient was only treated with romiplostim.
  
  
  RESULTS
  Ten patients responded to eltrombopag, and 4 of these patients experienced a transient loss of response following infection. Two patients developed bleeding symptoms, with 1 of these patients requiring platelet transfusion. All 3 patients treated with romiplostim responded, and 1 of these patients experienced also a transient loss of response following infections.
  
  
  CONCLUSIONS
  Patients receiving treatment with TM may experience adverse platelet count fluctuations during infections.
authors.affiliation: Charité - Universitätsmedizin Berlin, Institut für Transfusionsmedizin, Berlin, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Meyer
authors.forename: Abdulgabar
authors.initials: A
authors.lastname: Salama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001565:Benzoates / Q000009:adverse effects* / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006834:Hydrazines / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D011720:Pyrazoles / Q000009:adverse effects* / Q000627:therapeutic use*; D011961:Receptors, Fc / Q000627:therapeutic use*; D053628:Receptors, Thrombopoietin / Q000819:agonists*; D011993:Recombinant Fusion Proteins / Q000009:adverse effects* / Q000627:therapeutic use*; D013926:Thrombopoietin / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001565:Benzoates; D006834:Hydrazines; D011720:Pyrazoles; D011961:Receptors, Fc; D053628:Receptors, Thrombopoietin; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim; C520809:eltrombopag