Eltrombopag for the Treatment of Immune Thrombocytopenia:  The Aegean Region of Turkey Experience

�zdemirk�ran, F�sun; Payz�n, Bahriye; Kiper, H. Demet; Kabuk�u, Sibel; Akg�n �a�l�yan, G�ls�m; Kahraman, Selda; G�kmen Sevindik, �m�r; Ceylan, Cengiz; Kad�k�yl�, G�rhan; �ahin, Fahri; Keskin, Ali; Arslan, �yk�; �zcan, Mehmet Ali; G�rg�n, G�lnur; Bolaman, Zahit; B�y�kke�eci, Filiz; Bilgir, Oktay; Alacac�o�lu, �nci; Vural, Filiz; Zafer G�kg�z, G�ray Saydam, Murat Tombulo�lu,

Eltrombopag for the Treatment of Immune Thrombocytopenia: The Aegean Region of Turkey Experience [Turk J Hematol]

Turk J Hematol. 2015; 32(4): 323-328 | DOI: 10.4274/Tjh.2014.0152

Eltrombopag for the Treatment of Immune Thrombocytopenia: The Aegean Region of Turkey Experience

F�sun �zdemirk�ran¹, Bahriye Payz�n¹, H. Demet Kiper², Sibel Kabuk�u³, G�ls�m Akg�n �a�l�yan⁴, Selda Kahraman⁵, �m�r G�kmen Sevindik⁶, Cengiz Ceylan⁷, G�rhan Kad�k�yl�⁸, Fahri �ahin², Ali Keskin³, �yk� Arslan⁴, Mehmet Ali �zcan⁶, G�lnur G�rg�n⁷, Zahit Bolaman⁸, Filiz B�y�kke�eci², Oktay Bilgir⁴, �nci Alacac�o�lu⁶, Filiz Vural², Murat Tombulo�lu, Zafer G�kg�z, G�ray Saydam²
¹Katip �elebi University Faculty of Medicine, Atat�rk Research and Education Hospital, Clinic of Hematology, �zmir, Turkey
²Ege University Faculty of Medicine, Department of Hematology, �zmir, Turkey
³Pamukkale University Faculty of Medicine, Department of Hematology, Denizli, Turkey
⁴Bozyaka Research and Education Hospital, Clinic of Hematology, �zmir, Turkey
⁵Ayd�n State Hospital, Clinic of Hematology, Ayd�n, Turkey
⁶Dokuz Eyl�l University Faculty of Medicine, Department of Hematology, �zmir, Turkey
⁷Tepecik Research and Education Hospital, Clinic of Hematology, �zmir, Turkey
⁸Adnan Menderes University Faculty of Medicine, Department of Hematology, Ayd�n, Turkey

INTRODUCTION: OBJECTIVE: Immune thrombocytopenia (ITP) is an immune mediated disease characterized by transient or persistent decrease of the platelet count to less than 100 � 109/l. Although it is included in a benign disease group, bleeding complications may be mortal. With a better understanding of the pathophysiology of the disease, thrombopoietin receptor agonists which came into use in recent years, seem to be an effective option in the treatment of resistant patients.
METHODS: In this study, retrospective data of 40 patients who were treated with Eltrombopag due to the diagnosis of refractory ITP in the Aegean region were examined and evaluated.
RESULTS: In the study total rate of response was 87%, and in the cases with response the median period that number of platelets reached over 50. � 109/l was determined as 19.5 (5-60) days.
DISCUSSION AND CONCLUSION: CONCLUSION: In one patient venous sinus thrombosis was observed and showed no other additional risk factor due to/ related to thrombosis. The other patient with complete response and irregular follow-up for 12 months was lost due to sudden death as the result of propable acute myocardial infarction.

Keywords: Immune thrombocytopenia, Thrombopoietin receptor agonist, Bleeding, Eltrombopag

�mm�n Trombositopeni Tedavisinde Eltrombopag: T�rkiye Ege B�lgesi Deneyimi

G�R�� ve AMA�: �mm�n trombositopeni (�TP), trombositlerin imm�n arac�l� y�k�m ile kal�c� veya ge�ici olarak 100x109/L alt�nda oldu�u bir hastal�kt�r. Selim hematolojik hastal�klar i�inde yer almas�na ra�men kanama komplikasyonlar� �l�mc�l olabilir. Hastal��n patofizyolojisi daha iyi anla��lmas� ile son y�llarda kullan�ma giren trombopoetin resept�r agonistleri, diren�li hastalar�n tedavisinde etkili bir se�enek olarak g�r�nmektedir.
Y�NTEM ve GERE�LER: Bu �al��mada Ege B�lgesi�nde refrakter �TP tan�s� ile eltrombopag ile tedavi edilen 8 farkl� merkezden 40 hastan�n retrospektif verileri incelenmi� ve de�erlendirilmi�tir.
BULGULAR: �al��mada toplam yan�t oran� %87 idi ve trombositlerin 50x109/L�nin �zerine ��kt�� medyan s�re 19,5 (5-60) g�n saptand�. Tromboz i�in ba�ka hi�bir ek risk fakt�r� bulunmayan bir hastada ven�z sin�s trombozu g�zlendi. On iki ayd�r tam yan�tl� izlenen ve d�zensiz takibe gelen bir di�er hasta olas� akut miyokard infarkt�s� sonucu geli�en ani �l�m nedeni ile kaybedildi.
TARTI�MA ve SONU�: Her ne kadar eltrombopag yan�tlar� tatmin edici olsa da, h�zl� ilerleyen trombositemiye ba�l� geli�ecek tromboembolik olaylar a��s�ndan, yak�n takip ve monitorizasyon gereklidir.

Anahtar Kelimeler: �mm�n trombositopeni, Trombopoetin reseptor agonisti, Kanama, Eltrombopag

F�sun �zdemirk�ran, Bahriye Payz�n, H. Demet Kiper, Sibel Kabuk�u, G�ls�m Akg�n �a�l�yan, Selda Kahraman, �m�r G�kmen Sevindik, Cengiz Ceylan, G�rhan Kad�k�yl�, Fahri �ahin, Ali Keskin, �yk� Arslan, Mehmet Ali �zcan, G�lnur G�rg�n, Zahit Bolaman, Filiz B�y�kke�eci, Oktay Bilgir, �nci Alacac�o�lu, Filiz Vural, Murat Tombulo�lu, Zafer G�kg�z, G�ray Saydam. Eltrombopag for the Treatment of Immune Thrombocytopenia: The Aegean Region of Turkey Experience. Turk J Hematol. 2015; 32(4): 323-328

Corresponding Author: F�sun �zdemirk�ran, T�rkiye

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