A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy
A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy
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一种用于治疗妊娠期免疫性血小板减少症的新型重组人血小板生成素疗法
DOI：
10.1182/blood-2017-01-761262
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发表时间：
2017-08-31
期刊：
影响因子：
20.3
通讯作者：
Hou, Ming
中科院分区：
文献类型：
--
作者：
Kong, Zhangyuan;Qin, Ping;Hou, Ming
本研究的目的是确定重组人血小板生成素（rhTPO）用于治疗妊娠期免疫性血小板减少症（ITP）的安全性和有效性。如果妊娠ITP患者的血小板计数低于30-100 × 10（9）/L，出现出血症状，对皮质类固醇和/或静脉注射免疫球蛋白（IVIG）无效，并且对血小板输注无效，则将其纳入研究。31例患者接受rhTPO治疗，初始剂量为300 U/kg，每日1次，共14天。23名患者有反应（74.2%），其中10名完全反应者（> 100310（9）/L）和13名反应者（30-1003 10（9）/L）。rhTPO明显改善了出血症状，即使在无反应者中也是如此。rhTPO耐受性良好。各有1例患者报告了头晕、疲乏和注射部位疼痛。在中位随访53周（范围39-68周）的婴儿中未观察到先天性疾病或发育迟缓。总之，rhTPO是妊娠期ITP患者潜在的安全有效的治疗选择。本研究为rhTPO及其他促血小板生成剂治疗妊娠期ITP的临床应用奠定了基础。
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 patients with ITP were enrolled in the study if they had a platelet count less than 30-100 x 10(9)/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 300 U/kg once daily for 14 days. Twenty-three patients responded (74.2%), including 10 complete responders (> 100310(9) /L) and 13 responders (30-1003 10(9) /L). It appears that rhTPO ameliorated the bleeding symptoms remarkably, even in the nonresponders. rhTPO was well tolerated. Dizziness, fatigue, and pain at an injection site were reported in 1 patient each. No congenital disease or developmental delays were observed in the infants in a median follow-up of 53 (range, 39-68) weeks. In conclusion, rhTPO is a potentially safe and effective treatment choice for patients with ITP during pregnancy. Ourwork has paved thewayfor further studyonthe clinical application ofrhTPOandother thrombopoietic agents for themanagement of ITP during pregnancy.