Lusutrombopag increases hematocytes in a compensated liver cirrhosis patient.
A 56-year-old Japanese man with liver cirrhosis (LC) due to hepatitis C virus was admitted to our hospital for radiofrequency ablation of residual tumor following lusutrombopag administration. Laboratory tests revealed thrombocytopenia and leukopenia. The patient's LC was managed, and he was classified as Child-Pugh A. After admission, lusutrombopag was administered for 7 days. The platelet count increased to over 50,000/mm3after 7-14 days and returned to previous levels 50 days after administration. Leukocyte and erythrocyte counts also increased in response to the treatment and stayed elevated for over 120 days. Lusutrombopag acts selectively on human thrombopoietin (TPO) receptors and activates signaling pathways that promote the proliferation and differentiation of bone marrow progenitor cells into megakaryocytes, consequently increasing the blood platelet count. However, the patient treated with lusutrombopag in our case study showed increased blood leukocyte and erythrocyte counts as well. Given that TPO receptors are reportedly expressed in not only megakaryocyte progenitor cells but also hematopoietic progenitors, lusutrombopag may potentially improve pancytopenia caused by LC and can be used for the recovery of blood counts before other treatments.
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan. saka-a@med.niigata-u.ac.jp.
Akira
A
Sakamaki
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Takayuki
T
Watanabe
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Satoshi
S
Abe
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Kenya
K
Kamimura
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Atsunori
A
Tsuchiya
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Masaaki
M
Takamura
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Hirokazu
H
Kawai
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Satoshi
S
Yamagiwa
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Shuji
S
Terai
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D002934:Cinnamates / Q000627:therapeutic use*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013844:Thiazoles / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000209:etiology
D002934:Cinnamates; D013844:Thiazoles; C000611387:lusutrombopag
Liver cirrhosis; Lusutrombopag; Thrombocytopenia; Thrombopoietin