Increased requirement for platelet transfusions concurrent with enhanced bleeding during romiplostim treatment in a patient with thrombocytopenia due to bone marrow failure.

摘要

Romiplostim is a thrombopoietic agent. It induces increases in platelet counts in both healthy adults and patients with idiopathic thrombocytopenia (ITP) [1]. At the age of 46 years (Nov. 2003), a female patient was diagnosed with aplastic anemia (AA) showing distinct bilinear bone marrow hypoplasia, specifically of megakaryo-cytic lineage. Allosensitization against HLA A3, A24, B7, B27 was already present at diagnosis of AA. Six months after triple therapy with cyclosporine A (CS A), corticosteroids, and antithymocyte globulin (ATG) [2], she achieved partial remission with no need for further transfusions for 5 years. CSA medication was stopped after 3 years.