Yeungnam Univ J Med.  2021 Apr;38(2):165-168. 10.12701/yujm.2020.00493.

Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia

• Lim HJ
• Lim YT
• Hah JO
• Lee JM

• KMID: 2515193
• DOI: http://doi.org/10.12701/yujm.2020.00493

Abstract

We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/μL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/μL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/μL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

Keyword

Child; Immune thrombocytopenia; Idiopathic thrombocytopenic purpura; Romiplostim; Treatment-free response

Figure

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  Fig. 1. Changes in the platelet count during romiplostim treatment. IVIG, intravenous immunoglobulin.

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  Fig. 2. Treatment course in a patient with chronic immune thrombocytopenia. The frequency of intravenous immunoglobulin (IVIG) administration was reduced after romiplostim treatment. Treatment included prednisone (PDS), IVIG, rituximab, oral cyclosporine (CsA), and romiplostim.

Reference

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