Use of eltrombopag in aplastic anemia in Europe.

Ecsedi, Matyas; Lengline, Étienne; Knol-Bout, Cora; Bosman, Paul; Eikema, Dirk-Jan; Afanasyev, Boris; Maschan, Alexei; Dreger, Peter; Halkes, Constantijn J M; Drexler, Beatrice; Cortelezzi, Agostino; Drénou, Bernard; Patriarca, Andrea; Bruno, Benedetto; Onofrillo, Daniela; Lanino, Edoardo; Pulanic, Drazen; Serventi-Seiwerth, Ranka; Garnier, Alice; Ljungman, Per; ... (2019). Use of eltrombopag in aplastic anemia in Europe. Annals of hematology, 98(6), pp. 1341-1350. Springer-Verlag 10.1007/s00277-019-03652-8

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Eltrombopag (ELT), an oral thrombopoietin receptor agonist, has recently emerged as a promising new drug for the treatment of aplastic anemia (AA). How ELT is used outside of clinical trials in the real-world setting and results of this treatment are not known. We conducted therefore a retrospective survey on the use of ELT in AA among EBMT member centers. We analyzed the 134 patients reported in our survey together with 46 patients recently published by Lengline et al. The median follow-up from start of ELT treatment was 15.3 months, with 85.6% patients alive at last follow-up. Importantly, only 28.9% of our patients received ELT according to the FDA/EMA label as monotherapy in the relapsed/refractory setting, whereas 16.7% received ELT upfront. The overall response rate in our cohort was 62%, very similar to the results of the pivotal ELT trial. In multivariate analysis, combination therapy with ELT/cyclosporine/ATG and response to previous therapy were associated with response. Overall survival was favorable with a 1-year survival from ELT start of 87.4%. We identified age, AA severity before ELT start and response to ELT as variables significantly associated with OS. Two patients transformed to MDS; other adverse events were mostly benign. In sum, ELT is used widely in Europe to treat AA patients, mostly in the relapsed/refractory setting. Response to ELT is similar to the clinical trial data across different age groups, treatment lines, and treatment combinations and results in favorable survival.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Rovó, Alicia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0939-5555

Publisher:

Springer-Verlag

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

17 Sep 2019 09:34

Last Modified:

24 Oct 2019 22:14

Publisher DOI:

10.1007/s00277-019-03652-8

PubMed ID:

30915499

Uncontrolled Keywords:

Aplastic anemia Eltrombopag Growth factors Immunosuppression

BORIS DOI:

10.7892/boris.133197

URI:

https://boris.unibe.ch/id/eprint/133197

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