Progression of bone marrow fibrosis with reticulin and collagen hyperplasia during treatment with the thrombopoietin receptor agonist romiplostim in a patient with immune thrombocytopenia

DOI Web Site PubMed 15 References
  • KIRITO Keita
    Department of Hematology/Oncology, University of Yamanashi
  • KOMATSU Norio
    Department of Hematology, Juntendo University School of Medicine

Bibliographic Information

Other Title
  • TPO受容体作動薬ロミプロスチムによって骨髄レチクリンおよびコラーゲン線維の増生を認めたITP
  • 症例報告 TPO受容体作動薬ロミプロスチムによって骨髄レチクリンおよびコラーゲン線維の増生を認めたITP
  • ショウレイ ホウコク TPO ジュヨウタイ サドウヤク ロミプロスチム ニ ヨッテ コツズイ レチクリン オヨビ コラーゲン センイ ノ ゾウセイ オ ミトメタ ITP

Search this article

Description

Romiplostim is a thrombopoietin (TPO) receptor agonist that has attracted attention as a novel drug for the treatment of refractory immune thrombocytopenia (ITP). However, bone marrow reticulin and collagen fibrosis during the long-term use of romiplostim has recently become a concern. Here, we present a patient with ITP who exhibited bone marrow fibrosis after the completion of a Japanese phase III clinical trial and long-term extension study of romiplostim. The patient was a 64-year-old woman. She was diagnosed with refractory ITP and participated in a clinical trial of romiplostim. Myeloblasts were found in her peripheral blood in Week 116 of treatment with romiplostim in the long-term extension study, and romiplostim was discontinued. In Week 118, teardrop cells appeared and she underwent a bone marrow biopsy. Results showed reticulin and collagen fiber hyperplasia and her platelet count decreased markedly to 0.4×104/μl with macroscopic hematuria. Thereafter, a reduced dose of romiplostim was resumed. Approximately one year after the resumption of romiplostim, a bone marrow biopsy revealed a decrease in reticulin and collagen fibrosis. Although few patients exhibited bone marrow fibrosis with TPO and the event may be reversible, our observations indicate that careful monitoring is required for general clinical use.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (3), 295-299, 2013

    The Japanese Society of Hematology

References(15)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top