Observation of the clinical efficacy of eltrombopag combined with rhTPO in the treatment of patients with immune thrombocytopenia unresponsive to hormones
Objective To explore the clinical effect of Eltrombopag combined with recombinant human thrombopoietin(rhTPO)in the treatment of hormone ineffective immune thrombocytopenia.Methods Between July 2020 and July 2023,a total of one hundred patients with steroid-resistant immune thrombocytopenia treated in Jinhua Hospital Affiliated to Medical College of Zhejiang University were allocated into rhTPO group(n=50)and a combined treatment group(n=50)according to treatment.Patients in both groups were treated with rhTPO and patients in the combined treatment group were treated with Eltrombopag in combination with this treatment.We compared the therapeutic outcomes,changes in T lymphocyte subsets post-treatment,alterations in platelet in combination with this treatment(PLT)counts during the course of treatment,the time to first PLT count ≥50x1010/L,variations in the percentage of B lymphocytes before and after treatment,modifications in bleeding scores pre and post-treatment,recurrence rates,and the incidence of adverse reactions between the two groups.Results The efficacy rate in the combined treatment group was significantly higher at 100％(50/50)compared to 88％(44/50)in rhTPO group(P＜0.05).Post-treatment,the levels of CD3+T cells,CD4+T cells,and CD8+T cells were higher in the combined treatment group than in the standard treatment group,whereas the CD4/CD8 ratio was lower in the combined treatment group(P＜0.05).PLT counts in the combined treatment group surpassed those in the standard treatment group at 1,2,and 3 months post-treatment(P＜0.05).Additionally,the time to achieve a PL T count of ≥5 ×1010/L,the percentage of B lymphocytes,and the bleeding scores were all significantly lower in the combined treatment group compared to the standard treatment group(P＜0.05).There were no significant differences between two groups in terms of recurrence rates and the occurrence of adverse reactions(P＞0.05).Conclusion Eltrombopag combined with rhTPO has a good clinical effect in the treatment of hormone ineffective immune thrombocytopenia patients,which could promote the promotion of platelets and reduce the adverse reactions.
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