Combination of two target agonists of the thrombopoietin and thrombopoietin receptor in the treatment of elderly patients with refractory immune thrombocytopenia

作     者：Jundong Zhang Zining Wang Haoran Chen Xuechun Lu Jundong Zhang;Zining Wang;Haoran Chen;Xuechun Lu

作者机构：Department of HematologyThe Second Medical CenterChinese PLA General Hospital BeijingNational Clinical Research Center for Geriatric DiseaseBeijing 100853China Medical School of Chinese PLABeijing 100853China Management SchoolShanxi Medical UniversityTaiyuanShanxi 030002China 

出 版 物：《Cancer Pathogenesis and Therapy》 (癌症发生与治疗（英文）)

年 卷 期：2023年第1卷第2期

页      面：154-156页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the National Key Research and Development Program of China(No.2020YFC2002706) the Army Health Care Special Project(No.19BJZ28). 

主　　题：Immune thrombocytopenia(ITP) TPO-MPL signaling Pathway rh-TPO Eltrombopag 

摘      要：Immune thrombocytopenia(ITP)is common in the elderly.Because of the coexistence of multiple diseases,there are many reservations regarding corticosteroid use in the elderly.Thrombopoietin(TPO)and its analogs can promote platelet production,but it is often difficult to correct TP in a short period.Recombinant human TPO(rh-TPO)acting on the cell membrane and the small-molecule TPO-receptor(MPL)agonist acting on the transmembrane receptor may have synergistic effects and accelerate platelet production because of different sites of action in the signaling pathway.In this study,two elderly patients with refractory ITP were successfully treated with two TPO-MPL signaling pathway agonists:recombinant human thrombopoietin(rh-TPO)and eltrombopag.This combination is safe with rapid and lasting effects.However,in elderly patients with refractory,recurrent,and glucocorticoid contraindications,the combination of different TPO agonists clinical efficacy and adverse reactions needs to be further evaluated.