Eltrombopag for the treatment of aplastic anemia: current perspectives.
Aplastic anemia (AA) is a potential life-threatening hematopoietic stem cell (HSC) disorder resulting in cytopenia. The mainstays of treatment for AA are definitive therapy to restore HSCs and supportive measures to ameliorate cytopenia-related complications. The standard definitive therapy is HSC transplantation for young and medically fit patients with suitable donors and immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporine for the remaining patients. A significant proportion of patients are refractory to IST or relapse after IST. Various strategies have been explored in these patients, including second course of antithymocyte globulin, high-dose cyclophosphamide, and alemtuzumab. Eltrombopag, a thrombopoietin mimetic, has recently emerged as an encouraging and promising agent for patients with refractory AA. It has demonstrated efficacy in restoring trilineage hematopoiesis, and this positive effect continues after discontinuation of the drug. There are ongoing clinical trials exploring the role of eltrombopag as a first-line therapy in moderate to severe AA and a combination of eltrombopag with IST in severe AA.
Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
Su Han
SH
Lum
Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
John D
JD
Grainger
D000074323:Alemtuzumab; D000741:Anemia, Aplastic / Q000188:drug therapy*; D061067:Antibodies, Monoclonal, Humanized / Q000737:chemistry / Q000494:pharmacology*; D000961:Antilymphocyte Serum / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D001565:Benzoates / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000737:chemistry / Q000494:pharmacology*; D016572:Cyclosporine / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D006412:Hematopoietic Stem Cells / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D006834:Hydrazines / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D011720:Pyrazoles / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*
D061067:Antibodies, Monoclonal, Humanized; D000961:Antilymphocyte Serum; D001565:Benzoates; D006834:Hydrazines; D007166:Immunosuppressive Agents; D011720:Pyrazoles; D000074323:Alemtuzumab; D016572:Cyclosporine; D003520:Cyclophosphamide; C520809:eltrombopag
aplastic anemia; c-Mpl receptors; eltrombopag; thrombopoietin
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