TY - JOUR
T1 - Romiplostim resistance in secondary failure of platelet recovery
AU - Deremer, David L.
AU - Katsanevas, Katerina
AU - Bradley, Amber
AU - Awan, Farrukh T.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - Romiplostim, a thrombopoietin mimetic, is FDA approved for the treatment of thrombocytopenia in patients with refractory immune thrombocytopenia. Given the success of thrombopoietin agonists in the treatment of immune thrombocytopenia, data in other clinical settings are emerging. In the bone marrow transplant setting, secondary failure of platelet recovery and persistent thrombocytopenia are associated with increased mortality. In this case, romiplostim was attempted in a chronic lymphocytic leukemia patient who underwent a matched, unrelated donor, non-myeloablative stem cell transplant. This patient experienced profound thrombocytopenia despite dose escalation. Anti-thrombopoietin or anti-romiplostim antibodies were not detected by specific assays. Furthermore, the patient remains in disease remission with full chimerism. This case demonstrates that heavily pre-treated patients with limited bone marrow reserve may not respond to thrombopoietin agonists.
AB - Romiplostim, a thrombopoietin mimetic, is FDA approved for the treatment of thrombocytopenia in patients with refractory immune thrombocytopenia. Given the success of thrombopoietin agonists in the treatment of immune thrombocytopenia, data in other clinical settings are emerging. In the bone marrow transplant setting, secondary failure of platelet recovery and persistent thrombocytopenia are associated with increased mortality. In this case, romiplostim was attempted in a chronic lymphocytic leukemia patient who underwent a matched, unrelated donor, non-myeloablative stem cell transplant. This patient experienced profound thrombocytopenia despite dose escalation. Anti-thrombopoietin or anti-romiplostim antibodies were not detected by specific assays. Furthermore, the patient remains in disease remission with full chimerism. This case demonstrates that heavily pre-treated patients with limited bone marrow reserve may not respond to thrombopoietin agonists.
KW - Secondary failure of platelet recovery
KW - allogeneic stem cell transplant
KW - chronic lymphocytic leukemia
KW - romiplostim
UR - http://www.scopus.com/inward/record.url?scp=84888113339&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84888113339&partnerID=8YFLogxK
U2 - 10.1177/1078155212469640
DO - 10.1177/1078155212469640
M3 - Article
C2 - 23292974
AN - SCOPUS:84888113339
SN - 1078-1552
VL - 19
SP - 369
EP - 372
JO - Journal of Oncology Pharmacy Practice
JF - Journal of Oncology Pharmacy Practice
IS - 4
ER -