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Christiansen CF, Risbo N, Ghanima W, Linder M, Bahmanyar S, Seesaghur A, Clouser M, Nørgaard M, Sørensen HT. Platelet response to romiplostim amongst patients with newly diagnosed, persistent, and chronic immune thrombocytopenia in routine clinical practice in Denmark, Sweden, and Norway. Br J Haematol 2024. [PMID: 39102877 DOI: 10.1111/bjh.19688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
Patient characteristics and platelet responses at romiplostim initiation according to the duration of immune thrombocytopenia (ITP) are poorly understood. Amongst romiplostim-exposed adults with ITP lasting ≥6 months during 2009-2018 in Denmark, Sweden, and Norway, we examined characteristics at romiplostim initiation, romiplostim dosage, and durable platelet response (≥75% of measurements ≥50 × 109/L at 14-24 weeks) for subcohorts with newly diagnosed (duration <3 months), persistent (3-12 months), or chronic (>12 months) ITP initiating romiplostim. The 285 romiplostim initiators comprised 81 (28%) with newly diagnosed, 47 (16%) with persistent, and 157 (55%) with chronic ITP. More patients with newly diagnosed ITP than longer ITP duration, had low comorbidity levels, two or more prior ITP therapies, and previous bleeding requiring hospitalisation. The median romiplostim doses were similar across subcohorts. During treatment, median platelet counts were similar across subcohorts (75-76 × 109/L), and the durable platelet response was 64.6%, 52.9%, and 52.7% for newly diagnosed, persistent, and chronic ITP, respectively. After treatment cessation, the median platelet count was 138 × 109/L, 68 × 109/L, and 71 × 109/L, respectively. In conclusion, newly diagnosed patients, compared with romiplostim initiators with longer disease duration, had more severe ITP, higher frequency of durable platelet response, and higher median platelet count after cessation.
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Affiliation(s)
| | - Nickolaj Risbo
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Waleed Ghanima
- Department of Medicine, Østfold Hospital Trust, Grålum, Norway
- Department of Hematology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marie Linder
- Clinical Epidemiology Division and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shahram Bahmanyar
- Clinical Epidemiology Division and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anouchka Seesaghur
- Center for Observational Research, Amgen, Uxbridge, UK
- Center for Observational Research, Amgen, Thousand Oaks, California, USA
| | - Mary Clouser
- Center for Observational Research, Amgen, Uxbridge, UK
- Center for Observational Research, Amgen, Thousand Oaks, California, USA
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Wang W, Tao S, Zhang X, Wang W, Xu Y, Liang W. The Value of Combined Detection of Megakaryocyte and Platelet Parameters for the Diagnosis of Primary Immune Thrombocytopenia. Clin Appl Thromb Hemost 2022; 28:10760296221106779. [PMID: 35924375 PMCID: PMC9358600 DOI: 10.1177/10760296221106779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective:To investigate the application value of bone marrow megakaryocyte count, the proportion of megakaryocytes at each stage, and the platelet parameter in the clinical diagnosis of primary immune thrombocytopenia (ITP). Methods: The megakaryocyte and platelet parameter level in 62 ITP and 40 control group patients were compared and analyzed. Linear correlation analysis, Pearson correlation analysis, and ROC curves were performed for the correlation between megakaryocytes and platelet parameters. Results: Compared to the control group, the total number of megakaryocytes, the promegakaryocytes the granular megakaryocytes (GMeg), and naked megakaryocytes (NMeg), MPV, and P-LCR% in the ITP group increased. All differences were statistically significant (P<0.05). While the proportion of platelet-producing megakaryocytes (PMeg), PLT, and PCT decreased in the ITP group. These differences were statistically significant (P < 0.05). PLT was strongly positively correlated with PCT (r = 0.921, p<0.01). PCT was weakly positively with MPV (r = 0.309, p<0.05). MPV was positively correlated with P-LCR (r = 0.856, p<0.01). PDW was weakly positively correlated with P-LCR (r = 0.296, p<0.05) and Meg (r = 0.301, p<0.05), and negatively correlated with PMeg (r = -0.336, p<0.05). ROC curve analysis showed that PLT, PCT MPV and P-LCR% gave a high sensitivity(100.0%,81.0%,74.6%,90.5%,respectively.) and specificity (100.0%, 92.5%, 80.0%, 77.5%, respectively.) in diagnosis of ITP. Conclusion: The combined analysis of bone marrow megakaryocyte count, the proportion of megakaryocyte classification at each stage, and platelet parameters have an important reference value for auxiliary diagnosis of ITP.
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Affiliation(s)
- Weiwei Wang
- Department of Clinical Laboratory, 87805Fuyang People's Hospital, Fuyang, Anhui, China
| | - Shuan Tao
- School of Medical, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
| | - Xia Zhang
- Department of Clinical Laboratory, 87805Fuyang People's Hospital, Fuyang, Anhui, China
| | - Weiguo Wang
- Department of Clinical Laboratory, 87805Fuyang People's Hospital, Fuyang, Anhui, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, 36639First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wei Liang
- Department of Laboratory Medicine, the Second People's Hospital of Lianyungang City, Jiangsu Province, China
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