Recombinant human thrombopoietin in the treatment of secondary immune thrombocytopenia

Objective To evaluate the efficacy and safety of recombinant human thrombopoietin(rhTPO)in the treatment of secondary immune thrombocytopenia(ITP). Methods The clinical data of 21 patients with secondary ITP in our hospital from January 2009 to October 2014 were reviewed retrospectively.All patients were treated with subcutaneous rhTPO 300 U/(kg·d).For the patients who achieved complete response or effective response in 4 four weeks,the intermittent maintenance therapy with rhTPO were conducted for 1-3 times a week last 3 months. Results Among the 21 secondary ITP patients,the complete response rates(CR),effective response rates(R)and overall response(OS)after 4 weeks of rhTPO treatment were 47.6%,19.0% and 66.7%,respectively.Compared with the value before the treatment,the highest average of the platelet count after the treatment was significantly higher(P＜0.01);14 patients received rhTPO intermittent maintenance therapy,whose the count of platelet after the 3 months treatment was significantly higher than that before the treatment(P＜0.05).But the percentage of Th,Tc and Tregs of secondary ITP patients had no remarkably changed as compared with those before the treatment(P＞0.05).The adverse reactions were found in 3 patients(14.3%),included pains in joints and muscles,fatigue and dizziness,and were relieved after the symptomatic treatment. Conclusion The rhTPO has significant clinical effect and good tolerance for secondary ITP patients,although it cannot improve the numbers of Treg cells.The intermittent maintenance therapy can get a longer benefit for the patients who achieved complete response or effective response after rhTOP continuous treatment.