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Review
. 2016 Sep 13:10:2833-2843.
doi: 10.2147/DDDT.S95715. eCollection 2016.

Eltrombopag for the treatment of aplastic anemia: current perspectives

Su Han Lum  1 , John D Grainger  1
Affiliations
Review

Eltrombopag for the treatment of aplastic anemia: current perspectives

Su Han Lum et al. Drug Des Devel Ther. .

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: aplastic anemia; c-Mpl receptors; eltrombopag; thrombopoietin.

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Figures

Figure 1
Figure 1
Current recommendation for management of severe aplastic anemia. Abbreviations: AA, aplastic anemia; ATG, antithymocyte globulin; HLA, human leukocyte antigen; HSCT, hematopoietic stem cell transplantation; IST, immunosuppressive therapy; SAA, severe AA.
Figure 2
Figure 2
Mechanism of action of eltrombopag. Abbreviation: TPO, thrombopoietin.
Figure 3
Figure 3
The clinical trials of eltrombopag in refractory AA. Note: Data from Olnes et al and Desmond et al. Abbreviation: AA, aplastic anemia.
See this image and copyright information in PMC

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