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Effects of thrombopoietin receptor agonists on procoagulant state in patients with immune thrombocytopenia.

Authors
  • Alvarez Román, M T
  • Fernández Bello, I
  • Arias-Salgado, E G
  • Rivas Pollmar, M I
  • Jiménez Yuste, V
  • Martín Salces, M
  • Butta, N V1
  • 1 Nora V. Butta, Unidad de Hematología, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain, Tel.: +34 917277000 x 42258, Fax: +34 3582211, E-mail: [email protected] , (Spain)
Type
Published Article
Journal
Thrombosis and Haemostasis
Publisher
Georg Thieme Verlag KG
Publication Date
Jul 03, 2014
Volume
112
Issue
1
Pages
65–72
Identifiers
DOI: 10.1160/TH13-10-0873
PMID: 24500066
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Thrombopoietin receptor agonists (TPO-RA) have recently been introduced for the treatment of immune thrombocytopenia (ITP), an anti-platelet-antibodies autoimmune disease. The observation of a low frequency of bleeding episodes despite their thrombocytopenia suggests the existence of a compensatory mechanism. This study aimed to evaluate the effect of TPO-RA treatment on platelet function and on the procoagulant state in ITP patients before (ITP-bR) and after responding (ITP-aR) to treatment. Plasma- and microparticle (MP)-associated procoagulant capacity from ITP patients was similar before and after responding to the TPO-RA regimen but higher than the healthy control values. High MP-associated procoagulant activity did not seem to be due to increased platelet activation, since platelet stimulation by agonists was reduced in ITP-bR and ITP-aR patients. It could be related to increased platelet apoptosis, evaluated in terms of surface phosphatidylserine (PS), observed in both ITP groups. In summary, TPO-RA treatment increased platelet count but did not ameliorate their function and did not change plasma- and MP-associated procoagulant state of ITP patient responders to this therapy.

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