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Eltrombopag for the treatment of aplastic anemia: current perspectives

Authors Lum SH, Grainger J

Received 27 March 2016

Accepted for publication 25 May 2016

Published 13 September 2016 Volume 2016:10 Pages 2833—2843


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Wei Duan

Su Han Lum, John D Grainger

Department of Blood and Marrow Transplant, Royal Manchester Children’s Hospital, Manchester, UK

Abstract: Aplastic anemia (AA) is a potential life-threatening hematopoietic stem cell (HSC) disorder resulting in cytopenia. The mainstays of treatment for AA are definitive therapy to restore HSCs and supportive measures to ameliorate cytopenia-related complications. The standard definitive therapy is HSC transplantation for young and medically fit patients with suitable donors and immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporine for the remaining patients. A significant proportion of patients are refractory to IST or relapse after IST. Various strategies have been explored in these patients, including second course of antithymocyte globulin, high-dose cyclophosphamide, and alemtuzumab. Eltrombopag, a thrombopoietin mimetic, has recently emerged as an encouraging and promising agent for patients with refractory AA. It has demonstrated efficacy in restoring trilineage hematopoiesis, and this positive effect continues after discontinuation of the drug. There are ongoing clinical trials exploring the role of eltrombopag as a first-line therapy in moderate to severe AA and a combination of eltrombopag with IST in severe AA.

Keywords: eltrombopag, aplastic anemia, thrombopoietin, c-Mpl receptors

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