Carpenedo Monica, Cantoni Silvia, Coccini Veronica, Fedele Marilena, Morra Enrica, Pogliani Enrico Maria
Hematology and Transplant Unit , A.O. San Gerardo, University of Milan Bicocca ; Milan, Italy.
Hematology and Oncology Department, A.O. Ospedale Niguarda Cà Granda , Milan, Italy.
Hematol Rep. 2015 Feb 24;7(1):5673. doi: 10.4081/hr.2015.5673.
Thrombopoietin mimetics are new treatment options for patients with immune throm-bocytopenia (ITP). Because of their mechanism of action, long-term administration was envisioned in order to maintain effective thrombopoiesis. We report on 30 romiplostim treated patients: 13/27 responders (48%) achieved stable platelet counts on a mean romiplostim dose of 2.43 µg/kg and were able to stop romiplostim after a mean of 44.3 weeks (range 12-122) on therapy with sustained response maintained at a mean of 26 months (range 12-52). No bleeding events occurred during the observational period. No specific patient's features nor pattern of early response seemed to predict for sustained response. However, patients achieving safe platelet counts at lower dosages are probably worth a try of therapy tapering and discontinuation. Our observations support feasibility of romiplostim safe suspension in a relevant proportion of ITP patients.
血小板生成素模拟物是免疫性血小板减少症（ITP）患者的新治疗选择。由于其作用机制，需要长期给药以维持有效的血小板生成。我们报告了30例接受罗米司亭治疗的患者：27例中有13例（48%）在平均罗米司亭剂量为2.43μg/kg时达到稳定的血小板计数，并在治疗平均44.3周（范围12 - 122周）后能够停用罗米司亭，持续缓解平均维持26个月（范围12 - 52个月）。观察期内未发生出血事件。没有特定的患者特征或早期反应模式似乎能预测持续缓解。然而，在较低剂量下达到安全血小板计数的患者可能值得尝试逐渐减少剂量并停药。我们的观察结果支持在相当比例的ITP患者中安全停用罗米司亭的可行性。
