Eltrombopag use in chronic immune thrombocytopenia of childhood: Results from nationwide therapeutic program

Abstract

Background: Thrombopoietin receptor agonists have been repeatedly confirmed to be safe, efficient, and well tolerated in pediatric patients with chronic immune thrombocytopenia (cITP). Material and methods: In this report, we present data summarizing the Polish experience of the use of eltrombopag in cITP patients, refractory to standard first-line care. Our analysis was based on clinical and epidemiological data from the Nationwide Therapeutic Program 2018-2020. Quality of the response to the eltrombopag treatment was defined according to the International Consensus Guidelines as follows: complete response (CR) defined as platelet count (PLT) ≥100 x 109/L and absence of bleeding; response (R) defined as PLT ≥30 x 109/L and at least two-fold increase in the baseline count and absence of bleeding. Results: We evaluated 60 patients (33 boys and 27 girls) with chronic and refractory ITP. Median age at beginning of treatment was 9.5 years. Median PLT at the first eltrombopag administration was 30 x 109/L. The median follow-up was 7 months (range, 3-22 months). After 1 week of treatment, response (R) was noted in 53.3% (95% confidence interval [CI]: 40.7%-66.0%) patients, and complete response (CR) was seen in 21.6% (95% CI: 11.2%-32.1%). We evaluated the long-term duration of the response and found that it was obtained in 84.4% (95% CI: 71.8%-97.0%) and 88.9% (95% CI: 77.0%-100%) of patients after 6 and 12 months, respectively, of eltrombopag therapy, while CR was reached, respectively, in 46.9% (95% CI: 29.6%-64.2%) and 29.6% (95% CI: 12.4%-46.9%) patients. No serious adverse events were reported. Conclusion: Our data support the safety and efficacy of eltrombopag use in cITP pediatric patients.