International Journal of Hematology

DOI: 10.1007/s12185-019-02638-6 Pages: 255-259

Glucocorticoids promote response to thrombopoietin-receptor agonists in refractory ITP: a case series

1. University of Washington, Division of Hematology, Department of Medicine

2. Seattle Cancer Care Alliance

3. Bloodworks NW Research Institute

4. Fred Hutchinson Cancer Research Center

Correspondence to:
Terry B. Gernsheimer
Tel: (206) 598-7172



A proportion of patients with immune thrombocytopenic purpura are refractory to multiple therapies including thrombopoietin-receptor agonists (TPO-RA). We report 10 patients who did not respond to a TPO-RA until the addition of a glucocorticoid. These patients were previously treated with a median of 6 therapies. One patient elected to discontinue both medications despite persistent thrombocytopenia. The remaining 9 patients continued on the combination of prednisone (doses 5 mg every other day to 10 mg daily) and a TPO-RA. Combination therapy with low dose glucocorticoid and a TPO-RA may be an option for patients unresponsive to a TPO-RA alone.

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