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A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy

Zhangyuan Kong, Ping Qin, Shan Xiao, Hai Zhou, Hong Li, Renchi Yang, Xiaofan Liu, Jianmin Luo, Zhichun Li, Guochao Ji, Zhongguang Cui, Yusheng Bai, Yuxia Wu, Linlin Shao, Jun Peng, Jun Ma and Ming Hou

Key points

  • rhTPO is a potentially effective and safe treatment option for ITP during pregnancy.

Abstract

The aim of this study was to determine the safety and efficacy of recombinant human thrombopoietin (rhTPO) for the management of immune thrombocytopenia (ITP) during pregnancy. Pregnant ITP patients were enrolled in the study if they had a platelet count of < 30 × 109/L, were experiencing bleeding manifestations, had failed to respond to corticosteroids and/or intravenous immunoglobulin (IVIG), and had developed refractoriness to platelet transfusion. Thirty-one patients received rhTPO at an initial dose of 300U/kg once daily for 14 days. Twenty-three patients responded (74.2%), including 10 complete responders (>100 × 109/L) and 13 responders (30-100 × 109/L). It appears that rhTPO ameliorated the bleeding symptoms remarkably, even in the non-responders. rhTPO was well tolerated. Dizziness, fatigue, and pain at an injection site were reported in one patient each. No congenital disease or developmental delays were observed in the infants in a median follow-up of 53 (39-68) weeks. In conclusion, rhTPO is a potentially safe and effective treatment choice for ITP patients during pregnancy. Our work has paved the way for further study on the clinical application of rhTPO and other thrombopoietic agents for the management of ITP during pregnancy. This study is registered at www.clinicaltrials.gov as NCT02391272.

  • Submitted January 9, 2017.
  • Accepted June 10, 2017.