Priporočila za zdravljenje primarne imunske trombocitopenije. Barbara Skopec
|
|
- Blake Mitchell
- 6 years ago
- Views:
Transcription
1 Priporočila za zdravljenje primarne imunske trombocitopenije Barbara Skopec
2 ITP = Idiopatična trombocitopenična purpura ITP = primarna imunska trombocitopenija Rodeghiero F, et al. Blood 2009;113:
3 diagnoza 6 mesecev diagnoza akutna ITP 3 meseci kronična ITP 12 mesecev novoodkrita ITP perzistentna ITP kronična ITP Rodeghiero F, et al. Blood 2009;113:
4 Blood 2010;115: International consensus report on the investigation and management of primary immune thrombocytopenia Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel J.B, Chong BH, Cines DB, Gernsheimer TB, Godeau B, Grainger J, Greer I, Hunt BJ, Imbach PA, Lyons G, McMillan R, Rodeghiero F, Sanz MA, Tarantino M, Watson S, Young J and Kuter DJ Blood 2011;117: The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia Neunert C, Lim W, Crowther M, Cohen A, Solberg L. Jr and Crowther MA
5 Recommendations for the diagnosis of ITP in children and adults Basic evaluation Tests of potential utility in the management of an ITP patient Tests of unproven or uncertain benefit Patient history Glycoprotein-specific antibody TPO Family history Antiphospholipid antibodies (including anticardiolipin and lupus anticoagulant) Reticulated platelets Physical examination Complete blood count and reticulocyte count Antithyroid antibodies and thyroid function Pregnancy test in women of childbearing potential PaIgG Platelet survival study Peripheral blood film Antinuclear antibodies Bleeding time Quantitative immunoglobulin level measurement * Viral PCR for parvovirus and CMV Serum complement Bone marrow examination (in selected patients; refer to text) Blood group (Rh) Direct antiglobulin test H pylori HIV Provan D et al. Blood 2010;115:168 86;
6 Diagnostika ITP Natančna anameza in status Celotna krvna slika Biokemične preiskave krvi Testi hemostaze Presejalni testi za sistemske bolezni veziva (HEP 2, ENA) ščitnični hormoni imunoglobulini kvantitativno Serologija na CMV, EBV, parvo B19, hepatitis B in C, HIV Dihalni test ali H.pylori antigen v blatu Punkcija kostnega mozga (pri starejših od 60 let in rezistentnih na glukokortikoide oz. pred splenektomijo)
7 Dejavniki, ki vplivajo na odločitev o načinu zdravljenja Cilj zdravljenja pri kronični ITP ni jasno določen in je odvisen od ravnotežja med učinkovitostjo in neželenimi učinki določenega načina zdravljenja 1 Sekundarna ITP Obsežnost krvavitev Zapleti specifičnega zdravljenja Sodelovanje bolnika Morebitni posegi, ki lahko povzročijjo krvavitve Dejavniki, ki vplivajo na odločitev 2,3 Prenašanje neželenih učinkov Dostopnost zdravniške oskrbe Aktivnost in življenski slog Pridružene bolezni, ki vplivajo na možne krvavitve Pričakovanja bolnika 1. Rodeghiero et al. Blood 2009;113: ; 2. Neunert et al. Blood 2011;117: ; 3. Provan et al. Blood 2010;115:168 86
8 Prvo zdravljenje ITP pri odraslih: ASH in ICR ASH glukokortikoidi IVIg, če potrebujemo hiter porast Tr IVIg (ali anti-d), če so glukokortikoidi kontraindicirani IVIg 1 g/kg v enkratnem odmerku ICR glukokortikoidi IVIg, če so glukokortikoidi kontraindicirani ali če ni odziva na zdravljenje ASH, American Society of Hematology; ICR, International Consensus Report Provan et al. Blood 2010;115: Neunert et al. Blood 2011;117:
9 Drugo zdravljenje ITP pri odraslih : ASH and ICR ASH zdravila TPO-R agonisti za rezistentne in neprimerne za splenektomijo TPO-R agonisti za nesplenektomirane, s tveganjem za krvavitev po eni liniji zdravljenja Rituximab za rezistentne s tveganjem za krvavitev Kirurško zdravljenje splenektomija ICR zdravila TPO-R agonisti Rituximab Ostala imunosupresivna zdravila ciklosporin Kirurško zdravljenje splenektomija ASH, American Society of Hematology; ICR, International Consensus Report Provan et al. Blood 2010;115: Neunert et al. Blood 2011;117:
10 Second-line treatment options (1) Treatment Time to response Response rate Duration of sustained response Azathioprine (1 2 mg/kg; max 150 mg/day) Cyclosporin A (5 mg/kg/day for 6 days, then mg/kg/day; titration to blood levels of ng/ml) Slow; may need to be continued for 3 6 months Up to two-thirds of patients 3 4-weeks Dose dependent; high response rate (50 80%) in small series Up to one-quarter of off-therapy patients maintain response Half of responders receiving low doses sustain remission (at least 2 years) Provan D et al. Blood 2010;115:168 86
11 Second-line treatment options (2) Treatment Cyclophosphamide (1 2 mg/kg orally daily, at least 16 weeks; or g/m 2 IV every 2 4 weeks, 1 3 doses) Danazol (200 mg 2 4 times daily) Dapsone ( mg) Provan D et al. Blood 2010;115: Time to response 1 16 weeks Response rate Duration of sustained response 14 85% Up to 50% 3 6 months 67% complete or partial response 46% in remission at median of 119 (±45) months; mean duration of therapy 37 months 3 weeks Up to 50% Up to two-thirds of responders off therapy
12 Second-line treatment options (3) Treatment Mycophenolate mofetil (1000 mg twice daily, at least 3 4 weeks) Rituximab (375 mg/m 2 weekly, 4 doses; lower doses [100 mg/m 2 ] may also be effective) TPO-R agonists: Eltrombopag (25 75 mg daily) Provan D et al. Blood 2010;115: Time to response Response rate 4 6 weeks Up to 75% of patients, complete response in 40% 1 8 weeks 60% of patients; complete response in 40% Duration of sustained response Sustained for short time after discontinuation Sustained response >3 5 years in 15 20% of responders, may require retreatment months to years later 2 weeks 70 80% Up to 5 years with continual administration of
13 Second-line treatment options (4) Treatment TPO-R agonists: Romiplostim (1 10 µg/kg subcutaneously weekly) Splenectomy Time to response Response rate 1 4 weeks 79 88% (splenectomised and nonsplenectomised, respectively) Two-thirds of patients achieve lasting response Duration of sustained response Up to 5 years with continual administration of the drug 1 24 days Response sustained in more than two-thirds of patients over 5 10 years with no additional treatment Provan D et al. Blood 2010;115:168 86
14 Probability of first CR according to the type of onset (insidious or acute). Ghanima W et al. Blood 2012;120: by American Society of Hematology
15 Priporočila za splenektomijo Splenektomija ima med zdravljenji 2. reda najvišji delež uspešnosti(80%) in remisije (60 70% po 5 10 letih) ICR in ASH jo priporočata kot zdravljenje 2.reda ICR priporoča odlog splenektomije do kronične faze (>12 mesecev) ASH predlaga zdravljenje s TPO-R agonisti in rituksimabom pred splenektomijo Ghanima W et al. Blood 2012;120:960 9; Provan D et al. Blood 2010;115:168 86; Neunert C et al. Blood 2011;117:
16 Zapleti splenektomije Z operacijo povezana morbiditeta in mortaliteta: krvavitve, okužbe, peripankreatični hematom Povečano tveganje za nastanek VT Doživljenjsko povečano tveganje za sepso povzročeno z enkapsuliranimi bakterijami (pneumococci, meningococci, Haemophilus influenzae) Ghanima W et al. Blood 2012;120:960 9
17 Preživetje brez ponovitve % Dolgotrajni učinek splenektomije 233 bolnikov (povprečna starost 33 let) >10 let spremljanja CR (n=180) Vsi bolniki (n=206) R (n=26) CR = Tr > 100 x 10 9 /L R = Tr x 10 9 /L CR+R = 88% Meseci po splenektomiji CR, popolni odgovor; R, odgovor Vianelli N et al. Haematologica 2013;98:875 80
18 Dolgotrajen učinek zdravljenja z rituximabom pri ITP skupaj Začetni odgovor 1 leto 2 leti 5 let 100% 57% 38% 31% 21% odrasli (N=376) CR - Tr > 150 x 10 9 /L PR - Tr x 10 9 /L Patel et al. Blood 2012;119:
19 Kaplan-Meier response duration curves after month 6 in patients who achieved sustained response (SR) after dexamethasone monotherapy, dexamethasone plus rituximab, and dexamethasone plus rituximab salvage therapy. Zaja F et al. Blood 2010;115:
20 agonisti TPO-R Indicirani za zdravljenje odraslih s kronično IT Kot druga linija zdravljenja za bolnike, pri kate 20
21 dolgotrajno zdravljenje s TPO agonisti eltrombopag Tr 50x10 9 /L v času pri 85% bolnikov romiplostim Tr 50x10 9 /L v času študije pri 95% bolnikov
22 Naša priporočila??? Kdaj splenektomija? Kdaj TPO-A? Kdaj rituksimab? Kdaj ostala imunosupresivna zdravila?
Update on the Management of Immune Thrombocytopenic Purpura (ITP) Dr Raymond Wong Department of Medicine & Therapeutics Prince of Wales Hospital
Update on the Management of Immune Thrombocytopenic Purpura (ITP) Dr Raymond Wong Department of Medicine & Therapeutics Prince of Wales Hospital Immune Thrombocytopenia (ITP) Immune-mediated acquired disease
More informationEvolution of clinical guidelines for ITP: Role of Romiplostim
Slovenian Haematological Society 16 April 2010, Podčetrtek Evolution of clinical guidelines for ITP: Role of Romiplostim Dr. Roberto Stasi Department of Haematology St George's Hospital London Is there
More informationContemporary perspectives and initial management of pediatric ITP. William Beau Mitchell, MD Weill Cornell Medical College New York, NY USA
Contemporary perspectives and initial management of pediatric ITP William Beau Mitchell, MD Weill Cornell Medical College New York, NY USA Case Presentation 5 year old female Bruises on trunk, extremities
More informationDiagnosis and Management of Immune Thrombocytopenias. Thomas L. Ortel, M.D., Ph.D. Duke University Medical Center 2 November 2016
Diagnosis and Management of Immune Thrombocytopenias Thomas L. Ortel, M.D., Ph.D. Duke University Medical Center 2 November 2016 Disclosures Research support: NIH, CDC, Eisai, Pfizer, Daiichi Sankyo, GlaxoSmithKline,
More informationTreatment pathway for adult patients with immune (idiopathic) thrombocytopenic purpura (ITP)
Prescribing Clinical Network Surrey (East Surrey CCG, Guildford & Waverley CCG, North West Surrey CCG, Surrey Downs CCG & Surrey Heath CCG) Crawley and Horsham & Mid-Sussex CCG Treatment pathway for adult
More informationthrombopoietin receptor agonists and University of Washington January 13, 2012
Tickle me eltrombopag: thrombopoietin receptor agonists and the regulation of platelet production Manoj Menon University of Washington January 13, 2012 Outline Clinical case Pathophysiology of ITP Therapeutic
More informationRemissions after long term use of romiplostim for immune thrombocytopenia
Published Ahead of Print on September 1, 2016, as doi:10.3324/haematol.2016.151886. Copyright 2016 Ferrata Storti Foundation. Remissions after long term use of romiplostim for immune thrombocytopenia by
More informationWhat is the next step after failure of steroids in ITP? Splenectomy & Rituximab
What is the next step after failure of steroids in ITP? Splenectomy & Rituximab Dr. Roberto Stasi Department of Haematology St George's Hospital and Medical School London Factors that contribute to ITP
More informationDr Kannan S Consultant Hematologist Sahyadri Speciality Hospital, Pune K E M Hospital, Pune
IMMUNE THROMBOCYTOPENIA Dr Kannan S Consultant Hematologist Sahyadri Speciality Hospital, Pune K E M Hospital, Pune ITP Megakaryocytes Definition of ITP Primary immune thrombocytopenia Platelet count
More informationOriginal Article Does the eltrompobag treatment safe or effective for refractory chronic immune thrombocytopenia patients?
Int J Clin Exp Med 2016;9(9):18707-18711 www.ijcem.com /ISSN:1940-5901/IJCEM0029952 Original Article Does the eltrompobag treatment safe or effective for refractory chronic immune thrombocytopenia patients?
More informationPlatelets, numbers and alternative functions Nichola Cooper Hammersmith Hospital Imperial College
Platelets, numbers and alternative functions 2018 Nichola Cooper Hammersmith Hospital Imperial College Discussion points today What do platelets do beyond clot formation? How are platelets made? How is
More informationExpert Review: Updates in Immune Thrombocytopenia. Reference Slides
Expert Review: Updates in Immune Thrombocytopenia Reference Slides Immune Thrombocytopenia (ITP): Overview ITP causality 1,2 Suboptimal platelet production Dysregulated adaptive immune system Increased
More informationCigna Drug and Biologic Coverage Policy
Cigna Drug and Biologic Coverage Policy Subject Romiplostim Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 4 References... 4 Effective Date... 12/15/2017 Next
More informationThrombocytopenia: a practial approach
Thrombocytopenia: a practial approach Dr. med. Jeroen Goede FMH Innere Medizin, Medizinische Onkologie, Hämatologie FAMH Hämatologie Chefarzt Hämatologie Kantonsspital Winterthur Outline Introduction and
More informationCurrent and evolving treatment strategies in adult immune thrombocytopenia
memo (2018) 11:241 246 https://doi.org/10.1007/s12254-018-0428-7 Current and evolving treatment strategies in adult immune thrombocytopenia Jan-Paul Bohn Michael Steurer Received: 31 May 2018 / Accepted:
More informationTHE OLD AND THE NEW OF ITP. Alison Street Malaysia April 2010
THE OLD AND THE NEW OF ITP Alison Street Malaysia April 2010 The Harrington-Hollingsworth Experiment Harrington et al. Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic
More informationQUICK REFERENCE Clinical Practice Guideline on the Evaluation and Management of Immune Thrombocytopenia (ITP)
QUICK REFERENCE 2011 Clinical Practice Guideline on the Evaluation and Management of Immune Thrombocytopenia (ITP) Presented by the American Society of Hematology, adapted from: The American Society of
More informationCase Report Chronic immune thrombocytopenia in a child responding only to thrombopoietin receptor agonist
Case Report Chronic immune thrombocytopenia in a child responding only to thrombopoietin receptor agonist Mohamed E. Osman Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi
More informationRESEARCH. Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, South Africa 2
Role of splenectomy for immune thrombocytopenic purpura (ITP) in the era of new second-line therapies and in the setting of a high prevalence of HIV-associated ITP K R Antel, 1 MB ChB, FCP (SA), MMed (Med);
More informationCase Report: Sustained Partial Response to Thrombopoietin-Receptor Ago nist-romiplo stim-in Therapy of Refractory Chronic Immune Thrombocytopenia
Med. J. Cairo Univ., Vol. 83, No. 1, September: 747-751, 2015 www.medicaljournalofcairouniversity.net Case Report: Sustained Partial Response to Thrombopoietin-Receptor Ago nist-romiplo stim-in Therapy
More informationIl Rituximab nella ITP
Il Rituximab nella ITP Monica Carpenedo U.O.C Ematologia e TMO, Ospedale San Gerardo, Monza Burning questions about Rituximab and ITP What is the mechanism of action? What is long term effect of treatment?
More informationScottish Medicines Consortium
Scottish Medicines Consortium romiplostim, 250 microgram vial of powder for solution for subcutaneous injection (Nplate ) No. (553/09) Amgen 08 May 2009 (Issued 4 September 2009) The Scottish Medicines
More informationScottish Medicines Consortium
Scottish Medicines Consortium eltrombopag, 25mg and 50mg film-coated tablets (Revolade ) No. (625/10) GlaxoSmithKline UK 09 July 2010 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationManagement of newly diagnosed immune thrombocytopenia: can we change outcomes?
REVIEW ARTICLE Management of newly diagnosed immune thrombocytopenia: can we change outcomes? Cindy E. Neunert Department of Pediatrics, Columbia University Medical Center, New York, NY Immune thrombocytopenia
More informationManagement of newly diagnosed immune thrombocytopenia: can we change outcomes?
IT ALL STARTS HERE: DISORDERS OF PRIMARY HEMOSTASIS Management of newly diagnosed immune thrombocytopenia: can we change outcomes? Cindy E. Neunert Department of Pediatrics, Columbia University Medical
More informationEfficacy and safety of eltrombopag in adult refractory immune thrombocytopenia
BLOOD RESEARCH VOLUME 50 ㆍ NUMBER 1 March 2015 ORIGINAL ARTICLE Efficacy and safety of eltrombopag in adult refractory immune thrombocytopenia Yeo-Kyeoung Kim, Seung-Sin Lee, Sung-Hoon Jeong, Jae-Sook
More informationClinical decision making in ITP: When to treat and how to treat
Clinical decision making in ITP: When to treat and how to treat Beng Hock Chong MBBS,PhD,FRACP, FRCPA,FRCP Professor of Medicine, University of New South Wales, Sydney and Director of Hematology, St George
More informationState of the art how I manage immune thrombocytopenia
review State of the art how I manage immune thrombocytopenia Nichola Cooper Hammersmith Hospital, Imperial College, London, UK Summary The management of patients with immune thrombocytopenia (ITP) is rapidly
More informationTavalisse (fostamatinib disodium hexahydrate)
Tavalisse (fostamatinib disodium hexahydrate) Policy Number: 5.01.661 Last Review: 07/2018 Origination: 07/2018 Next Review: 07/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide
More informationImmune Thrombocytopenia (ITP)
Immune Thrombocytopenia (ITP) ITP - What is it? ITP is a blood disorder affecting platelets in the blood. Platelets are small cells in your blood that help your blood to clot. In ITP the body s immune
More informationPediatric Immune Thrombocytopenia (ITP) Cindy E. Neunert MD, MSCS Associate Professor, Pediatrics Columbia University Medical Center New York, NY
Pediatric Immune Thrombocytopenia (ITP) Cindy E. Neunert MD, MSCS Associate Professor, Pediatrics Columbia University Medical Center New York, NY Objectives Review the 2011 American Society of Hematology
More informationORIGINAL ARTICLE. Ann Hematol (2016) 95: DOI /s
Ann Hematol (2016) 95:1077 1087 DOI 10.1007/s00277-016-2682-2 ORIGINAL ARTICLE Changes in bone marrow morphology in adults receiving romiplostim for the treatment of thrombocytopenia associated with primary
More informationImmune Thrombocytopenia. A Practical Guide for Nurses and Other Allied Healthcare Professionals
Immune Thrombocytopenia A Practical Guide for Nurses and Other Allied Healthcare Professionals Contents Chapter 1: Overview of immune thrombocytopenia 3 Chapter 2: Identifying immune thrombocytopenia 7
More informationUKITP INITAL INFORMATION SHEET (2.4)
UKITP INITAL INFORMATION SHEET (2.4) Barts Health NHS Trust The Royal London Hospital Pathology and Pharmacy Building 80 Newark Street, London E1 2ES Centre for Haematology Institute of and Molecular Science
More informationSecond line therapy for ITP should be TPO agonists. Nichola Cooper Imperial Health Care NHS Trust
Second line therapy for ITP should be TPO agonists Nichola Cooper Imperial Health Care NHS Trust COHEM 2012 Antiplatelet antibodies Platelet count after infusion with patient plasma Hours Days T cells
More informationPromacta (eltrombopag)
Promacta (eltrombopag) Policy Number: 5.01.542 Last Review: 5/2018 Origination: 6/2013 Next Review: 5/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Promacta
More informationIdiophatic Thrombocytopenic Purpura: Current Concepts In Pathophysiology And Management
Slovenian Society of Hematology Kranjska Gora, 3-4 October 2008 Idiophatic Thrombocytopenic Purpura: Current Concepts In Pathophysiology And Management Dr. Roberto Stasi S.C. di Oncologia ed Ematologia
More informationCancer Biology 2016;6(3) Immune Thrombocytopenia: Single Institute Experience. Mohammed A. Albalawi, MD
Immune Thrombocytopenia: Single Institute Experience Mohammed A. Albalawi, MD Medicine department, College of Medicine, Taibah University. Email: albalawi_21@hotmail.com Abstract: Immune thrombocytopenia
More informationThe ITP Patient Advocate
The ITP Patient Advocate A Resource for Your Journey With Chronic ITP Visit nplate.com for more information Issue Two Medical News About Nplate This issue looks at a recent 1-year Nplate medical study
More informationImmune Thrombocytopenia
Immune Thrombocytopenia David J. Kuter, MD, Dphil Massachusetts General Hospital 2015 Highlights of ASH in Asia Bangkok, Thailand February 28 March 1 Common Causes of Thrombocytopenia Infections Viral
More informationAcute Immune Thrombocytopenic Purpura (ITP) in Childhood
Acute Immune Thrombocytopenic Purpura (ITP) in Childhood Guideline developed by Robert Saylors, MD, in collaboration with the ANGELS team. Last reviewed by Robert Saylors, MD September 22, 2016. Key Points
More informationThrombopoietin Receptor Agonists Prior Authorization with Quantity Limit Program Summary
Thrombopoietin Receptor Agonists Prior Authorization with Quantity Limit Program Summary Thrombopoietin Receptor Agonists Prior Authorization with Quantity Limit OBJECTIVE The intent of the prior authorization
More informationHematology, Transfusion and Cell Therapy
hematol transfus cell ther. 2018;40(1):50 74 Hematology, Transfusion and Cell Therapy www.rbhh.org Special article Guideline on immune thrombocytopenia in adults: Associação Brasileira de Hematologia,
More informationLong-Term Use of the Thrombopoietin-Mimetic Romiplostim in Children With Severe Chronic Immune Thrombocytopenia (ITP)
Pediatr Blood Cancer 2015;62:208 213 Long-Term Use of the Thrombopoietin-Mimetic Romiplostim in Children With Severe Chronic Immune Thrombocytopenia (ITP) James B. Bussel, MD, 1 * Loan Hsieh, MD, 2 George
More informationCorso Nazionale di Aggiornamento in Ematologia Clinica Bolzano giugno 2009
Corso Nazionale di Aggiornamento in Ematologia Clinica Bolzano 18-19 giugno 2009 Nuove prospettive terapeutiche nelle piastrinopenie autoimmuni Marco Ruggeri UO Ematologia, Ospedale San Bortolo, Vicenza
More informationREVIEW ARTICLE. Immune Thrombocytopenic Purpura ADARSH A K, LAKSHMI KRISHNA INTRODUCTION CLASSIFICATION
ADARSH A K, LAKSHMI KRISHNA REVIEW ARTICLE INTRODUCTION ITP or immune thrombocytopenic purpura is an autoimmune disorder characterized by increased platelet destruction & platelet count < 1 lakh. It is
More informationCase Presentation. A Case from the Clinic. Additional Data. Examination and Data 10/27/2013
Northwestern University Feinberg School of Medicine Treatment of Severe Thrombocytopenia in Systemic Lupus Erythematosus: The Role of New Agents Disclosures: Advisory Board: Incyte Corporation Speaker
More informationINTRODUCTION TO SET FORTH APROACH TO MANAGING ADULTS TO SET FORTH APROACH PRIMARY ( PRIMARY AUTOIMMUNE) AUTOIMMUNE ITP FROM ASH & THE BRITISH
HOW I TREAT IDIOPATHIC THROMBOCYTOPENIC PURPURA Dauglas B. Cines, James B Bussel. Blood Oktober 2005:106(7):2244-22512251 INTRODUCTION TO SET FORTH APROACH TO MANAGING ADULTS PRIMARY (AUTOIMMUNE) ITP FROM
More informationManagement of immune thrombocytopenia: Korean experts recommendation in 2017
BLOOD RESEARCH VOLUME 52 ㆍ NUMBER 4 December 2017 REVIEW ARTICLE Management of immune thrombocytopenia: Korean experts recommendation in 2017 Jun Ho Jang 1#, Ji Yoon Kim 2#, Yeung-Chul Mun 3, Soo-Mee Bang
More informationWhen and how to treat childhood immune
When and how to treat childhood immune Abstract: Childhood immune thrombocytopenia is an autoimmune process resulting in an isolated thrombocytopenia that puts the child at risk for bleeding and can negatively
More informationLong-term results of laparoscopic splenectomy in pediatric chronic immune thrombocytopenic purpura
ORIGINAL ARTICLE pissn 2288-6575 eissn 2288-6796 http://dx.doi.org/10.4174/astr.2014.86.6.314 Annals of Surgical Treatment and Research Long-term results of laparoscopic splenectomy in pediatric chronic
More informationAntikoagulantno zdravljenje
Antikoagulantno zdravljenje (novosti s kongresa ASH 2010) Irena Umek Bricman Oddelek za interno medicino SB Slovenj Gradec Podčetrtek, 15.04.2010 Trajanje antikoagulantne terapije Priporočila: 8th ACCP
More informationCommittee Approval Date: May 9, 2014 Next Review Date: May 2015
Medication Policy Manual Policy No: dru180 Topic: Promacta, eltrombopag Date of Origin: May 8, 2009 Committee Approval Date: May 9, 2014 Next Review Date: May 2015 Effective Date: June 1, 2014 IMPTANT
More informationHydroxychloroquine is a good second-line treatment for adults with immune thrombocytopenia and positive antinuclear antibodies
AJH Hydroxychloroquine is a good second-line treatment for adults with immune thrombocytopenia and positive antinuclear antibodies Mehdi Khellaf, 1 * Amèlie Chabrol, 1 Matthieu Mahevas, 1 Françoise Roudot-Thoraval,
More informationRevolade Approved in EU as First in Class Therapy for Children Aged 1 Year and Above with Chronic ITP
April 7, 2016 Revolade Approved in EU as First in Class Therapy for Children Aged 1 Year and Above with Chronic ITP Revolade is marketed as Promacta in the United States EU approval of Revolade expands
More informationDrug Class Review: Thrombocytopenia
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-2596
More informationMost Common Hemostasis Consults: Thrombocytopenia
Most Common Hemostasis Consults: Thrombocytopenia Cindy Neunert, MS MSCS Assistant Professor, Pediatrics CUMC Columbia University TSHNA Meeting, April 15, 2016 Financial Disclosures No relevant financial
More informationAnn Janssens, MD, PhD. Department of Hematology, UZ Leuven BHS course 8 november 2014
Ann Janssens, MD, PhD Department of Hematology, UZ Leuven BHS course 8 november 2014 The history of platelets, megakaryocytes and thrombopoietin Platelet homeostasis etpo Production Platelet Pool Normal
More informationSecond-line therapies in immune thrombocytopenia
WHEN ANTIBODY RESPONSE GOES AWRY Second-line therapies in immune thrombocytopenia Rachael F. Grace 1 and Cindy Neunert 2 1 Pediatric Hematology/Oncology, Dana-Farber/Boston Children s Cancer and Blood
More information* Corresponding Author: Rajarshi Basu
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 10 Ver. I (Oct. 2017), PP 49-55 www.iosrjournals.org Comparison of Single Course High-Dose
More informationAnalysis of EQ-5D scores from two phase 3 clinical trials of romiplostim in the treatment of immune thrombocytopenia (ITP)
available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/jval Analysis of EQ-5D scores from two phase 3 clinical trials of romiplostim in the treatment of immune thrombocytopenia (ITP)
More informationZdravljenje pridobljene hemofilije. Irena Preložnik Zupan
Zdravljenje pridobljene hemofilije Irena Preložnik Zupan CILJI 1. Definicija, klinična slika, diagnoza 2. Zdravljenje zdravljenje akutnih krvavitev odstranjevanje inhibitorjev Pridobljeni inhibitorji koagulacije
More informationDepartments of Pediatrics and Medicine, Division of Hematology/Oncology, Weill Cornell Medical College, New York, NY, USA; ABSTRACT
ARTICLES Platelet Disorders Rituximab and three dexamethasone cycles provide responses similar to splenectomy in women and those with immune thrombocytopenia of less than two years duration James B. Bussel,
More informationClinical Policy Bulletin: Romiplostim (Nplate)
Romiplostim (Nplate) Page 1 of 8 Aetna Better Health 2000 Market Suite Ste. 850 Philadelphia, PA 19103 AETNA BETTER HEALTH Clinical Policy Bulletin: Romiplostim (Nplate) Number: 0768 Policy Aetna considers
More informationPediatric Hematology/Oncology: Blood, Body, and Beyond. Geoffrey S. Kannan, PhD, MD Pediatric Neuro-oncology Pediatric Hematology/Oncology
Pediatric Hematology/Oncology: Blood, Body, and Beyond Geoffrey S. Kannan, PhD, MD Pediatric Neuro-oncology Pediatric Hematology/Oncology Disclosures Nothing to disclose Discuss standard of care for common
More informationImmune thrombocytopenic purpura presenting in a patient after renal transplant for diabetic nephropathy
Rashid et al. BMC Nephrology (2018) 19:69 https://doi.org/10.1186/s12882-018-0868-7 CASE REPORT Open Access Immune thrombocytopenic purpura presenting in a patient after renal transplant for diabetic nephropathy
More informationCurrent management of immune thrombocytopenia
DISORDERS OF PLATELET DESTRUCTION Current management of immune thrombocytopenia Cindy E. Neunert 1 1 Department of Pediatrics and Cancer Center, Georgia Regents University, Augusta, GA Immune thrombocytopenia
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Promacta) Reference Number: CP.PHAR.180 Effective Date: 03.01.16 Last Review Date: 02.18 Line of Business: Commercial, Health Insurance Marketplace, Medicaid Revision Log See Important
More informationAppendix to Notification Letter for rituximab and eltrombopag dated 20 February 2014
Appendix to Notification Letter for rituximab and eltrombopag dated 20 February 2014 The notification letter which contains details of the decision to widen the restriction criteria for rituximab and eltrombopag
More informationImmune Thrombocytopenia among Children Living at a High Altitude Region: A Hospital-Based Retrospective Study
Med. J. Cairo Univ., Vol. 82, No. 2, December: 87-93, 2014 www.medicaljournalofcairouniversity.net Immune Thrombocytopenia among Children Living at a High Altitude Region: A Hospital-Based Retrospective
More informationRituximab for the treatment of Immune (Idiopathic) Thrombocytopenic Purpura (ITP)
Rituximab for the treatment of Immune (Idiopathic) Thrombocytopenic Purpura (ITP) Lead author: Stephen Erhorn Regional Drug & Therapeutics Centre (Newcastle) February 2015 2015 Summary Rituximab (MabThera,
More informationCase Report Myelofibrosis Associated with Romiplostim Treatment in a Patient with Immune Thrombocytopenia
Volume 2012, Article ID 318597, 4 pages doi:10.1155/2012/318597 Case Report Myelofibrosis Associated with Romiplostim Treatment in a Patient with Immune Thrombocytopenia Maria Fernanda Gonzalez and Jonathan
More informationComplement Blockade with C1 Esterase Inhibitor in Refractory Immune Thrombocytopenia
THROMBOCYTOPENIA Complement Blockade with C1 Esterase Inhibitor in Refractory Immune Thrombocytopenia Erin Roesch, MD, and Catherine Broome, MD Abstract Immune thrombocytopenia (ITP) is a disease process
More informationMEDICAL COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 08/19/14 SECTION: DRUGS LAST REVIEW DATE: LAST CRITERIA REVISION DATE: ARCHIVE DATE:
RITUXAN (rituximab) Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical Coverage Guideline
More informationKeywords evidence evaluation, practice guidelines, conflicts of interest, immune thrombocytopenia
481618AJMXXX10.1177/1062860613481618American Journal of Medical QualityGeorge et al research-article2013 Article Conflicts of Interest and Clinical Recommendations: Comparison of Two Concurrent Clinical
More informationManagement of Acute ITP in Children Fifteen Years Experience
Cronicon OPEN ACCESS EC PAEDIATRICS Research Article Management of Acute ITP in Children Fifteen Years Experience Jalil I Alezzi* Pediatric Department, College of Medicine, Hadhramout University, Yemen
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,500 108,000 1.7 M Open access books available International authors and editors Downloads Our
More informationClinical Policy: Eltrombopag (Promacta) Reference Number: ERX.SPA.71 Effective Date:
Clinical Policy: (Promacta) Reference Number: ERX.SPA.71 Effective Date: 10.01.16 Last Review Date: 11.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationOriginal Article Epidemiology of Idiopathic Thrombocytopenic Purpura in Children
Original Article Epidemiology of Idiopathic Thrombocytopenic Purpura in Children Nazari SH MD 1, Abdollah Gorji F MSc 2, Sadeghi-Koupai MT PhD 3 Downloaded from ijpho.ssu.ac.ir at 22:18 IRST on Saturday
More informationTechnology appraisal guidance Published: 27 April 2011 nice.org.uk/guidance/ta221
Romiplostim for the treatment of chronic immune (idiopathic) thrombocytopenic purpura Technology appraisal guidance Published: 27 April 2011 nice.org.uk/guidance/ta221 NICE 2018. All rights reserved. Subject
More informationCASE REPORT. Juno Yang, KMD, PhD 1,a Beom-Joon Lee, KMD, PhD 2,a and Jun-Hwan Lee, KMD, PhD 3,4#
CASE REPORT CASE REPORTS OF IDIOPATHIC THROMBOCYTOPENIA UNRESPONSIVE TO FIRST-LINE THERAPIES TREATED WITH TRADITIONAL HERBAL MEDICINES BASED ON SYNDROME DIFFERENTIATION Juno Yang, KMD, PhD 1,a Beom-Joon
More informationwith low-dose rituximab in combination with recombinant human thrombopoietin in treating ITP Y. LI, Y.-Y. WANG, H.-R. FEI, L. WANG, C.-L.
European Review for Medical and Pharmacological Sciences Efficacy of low-dose rituximab in combination with recombinant human thrombopoietin in treating ITP Y. LI, Y.-Y. WANG, H.-R. FEI, L. WANG, C.-L.
More informationHealth-related quality of life in children with chronic immune thrombocytopenia in China
Zhang et al. Health and Quality of Life Outcomes (2016) 14:45 DOI 10.1186/s12955-016-0445-3 RESEARCH Open Access Health-related quality of life in children with chronic immune thrombocytopenia in China
More informationMisdiagnosis of primary immune thrombocytopenia and frequency of bleeding: lessons from the McMaster ITP Registry
REGULAR ARTICLE Misdiagnosis of primary immune thrombocytopenia and frequency of bleeding: lessons from the McMaster ITP Registry Donald M. Arnold, 1-3 Ishac Nazy, 1,2 Rumi Clare, 1 Anushka M. Jaffer,
More informationPrognostic factors for positive immune thrombocytopenic purpura outcome after laparoscopic splenectomy
Cent. Eur. J. Med. 6(1) 2010 123-130 DOI: 10.2478/s11536-010-0063-0 Central European Journal of Medicine Prognostic factors for positive immune Mindaugas Kiudelis 1*, Antanas Mickevicius 1, Ruta Dambrauskiene
More informationImmune Thrombocytopenic Purpura (ITP)
Patient information Immune Thrombocytopenic Purpura Immune Thrombocytopenic Purpura (ITP) This leaflet is for adult patients diagnosed with Immune Thrombocytopenic Purpura also known as Immune Thrombocytopenia
More informationJacquelyn Zimmerman, Kelly J. Norsworthy, and Robert Brodsky. 1. Introduction
Case Reports in Hematology Volume 2016, Article ID 5403612, 4 pages http://dx.doi.org/10.1155/2016/5403612 Case Report Balancing Therapy with Thrombopoietin Receptor Agonists and Splenectomy in Refractory
More informationIdiopathic thrombocytopenic purpura in children: A 10 years experience at tertiary care hospital
1358 ORIGINAL ARTICLE Idiopathic thrombocytopenic purpura in children: A 10 years experience at tertiary care hospital Naureen Mushtaq, Muhammad Matloob Alam, Zehra Fadoo Abstract Objective: To evaluate
More informationLow platelet count as risk factor for infections in patients with primary immune thrombocytopenia: a retrospective evaluation
Annals of Hematology (2018) 97:1701 1706 https://doi.org/10.1007/s00277-018-3367-9 ORIGINAL ARTICLE Low platelet count as risk factor for infections in patients with primary immune thrombocytopenia: a
More informationApproach to thrombocytopenia and management of ITP. Dr.Aby Abraham Dept of Clinical Haematology
Approach to thrombocytopenia and management of ITP Dr.Aby Abraham Dept of Clinical Haematology 04-08-2014 Causes of thrombocytopenia Thrombocytopenia Pseudo True Decreased production Increased destruction
More informationChronic immune thrombocytopenic purpura-who needs medication?
Chronic immune thrombocytopenic purpura-who needs medication? Paula H. B. Bolton-Maggs, Victoria S. L. Kok To cite this version: Paula H. B. Bolton-Maggs, Victoria S. L. Kok. Chronic immune thrombocytopenic
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Single Technology Appraisal (STA) Eltrombopag for adult patients with chronic immune thrombocytopenic purpura (citp) August 2012 Eltrombopag for adult
More informationImmune Thrombocytopenia (ITP) A resource for healthcare professionals
Immune Thrombocytopenia (ITP) A resource for healthcare professionals Dear Colleague It is with great pleasure that we present the learning program: Immune thrombocytopenia (ITP): A resource for healthcare
More informationVolume 4, Issue 1, March 2013 REPRINT. Primary immune thrombocytopenia in adults
BELGIAN SOCIETY Belgian Journal of Hematology The Belgian Journal of Hematology is the official journal of the Belgian Hematological Society (BHS), the Belgian Society on Thrombosis and Haemostasis (BSTH),
More informationeltrombopag (Promacta )
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
More informationRituximab for the treatment of adults with idiopathic (immune) thrombocytopenic purpura (ITP)
Bedfordshire and Luton Joint Prescribing Committee Date: September 2015 Review date: September 2018 Bullletin 221: Rituximab (MabThera ) for the treatment of adults with idiopathic (immune) thrombocytopenic
More informationHigh Remission Rate of Chronic Immune Thrombocytopenia in Children: Result of 20-Year Follow-Up
Original Article Yonsei Med J 216 Jan;57(1):127-131 pissn: 513-5796 eissn: 1976-2437 High Remission Rate of Chronic Immune Thrombocytopenia in Children: Result of 2-Year Follow-Up Chae Young Kim, Eun Hye
More informationEltrombopag for the treatment of chronic immune thrombocytopenic purpura (ITP): A Single Technology Appraisal
Eltrombopag for the treatment of chronic immune thrombocytopenic purpura (ITP): A Single Technology Appraisal Produced by: Aberdeen HTA Group Authors: Ewen Cummins Shona Fielding Neil Scott 2 Kieran Rothnie
More informationEltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura (review of technology appraisal 205)
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Final appraisal determination Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura (review of technology appraisal 205) This guidance
More information