title: TPO-RAs in pITP: description of a case series and analysis of predictive factors for response.
abstract: OBJECTIVE
  To report our experience concerning sustained response (SR) after TPO-RA discontinuation in adult pITP patients and to identify possible predictive factors for outcome.
  
  
  METHODS
  Thirty-nine pITP patients who received a TPO-RA were evaluated. Response (R) was defined as a platelet count ≥30 × 109/L and at least a twofold increase in the baseline count and complete response (CR) as a platelet count ≥100 × 109/L, in the absence of bleeding. Durable response (DR) was defined as a R/CR persisting ≥4 wk with a stable dose of TPO-RA, and SR as the first assessed platelet count ≥30 × 109/L, available at more than 4 wk after discontinuation of TPO-RA, in the absence of other concomitant or rescue therapies.
  
  
  RESULTS
  Twenty-nine/39 (74%) were responders: 18 (46%) reached a CR and 11 (28%) a R. A DR was observed in 16/29 (55%) responders. Seven SR (18%) were reached: five of seven patients achieved a SR from a prior DR. CR was statistically associated with the achievement of a subsequent DR: 13/18 (72%) CR patients obtained a DR, while only three of 11 (27%) R ones did (P = 0.027).
  
  
  CONCLUSIONS
  CR was a significant prognostic factor for the achievement of a DR. Moreover, we observed a trend for DR patients to obtain a subsequent SR.
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Maria Gabriella
authors: MG
authors: Mazzucconi
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Cristina
authors: C
authors: Santoro
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Erminia
authors: E
authors: Baldacci
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Federico
authors: F
authors: De Angelis
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Marta
authors: M
authors: Chisini
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Grazia
authors: G
authors: Ferrara
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Paola
authors: P
authors: Volpicelli
authors: Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy.
authors: Roberto
authors: R
authors: Foà
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001565:Benzoates / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D011720:Pyrazoles / Q000627:therapeutic use; D011961:Receptors, Fc / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013926:Thrombopoietin / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001565:Benzoates; D006834:Hydrazines; D011720:Pyrazoles; D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim; C520809:eltrombopag
keywords: eltrombopag; immune thrombocytopenia; romiplostim; therapy; thrombopoietin receptor agonists