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Title of Journal: Int J Hematol

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Abbravation: International Journal of Hematology

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Springer Japan

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DOI

10.1007/978-90-481-3071-9_54

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1865-3774

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Identification of antithrombopoietin receptor ant

Authors: Akihito Fujimi Yusuke Kamihara Akari Hashimoto Yuji Kanisawa Chisa Nakajima Naotaka Hayasaka Shota Yamada Toshinori Okuda Shinya Minami Kaoru Ono Satoshi Iyama Junji Kato
Publish Date: 2015/05/13
Volume: 102, Issue: 4, Pages: 471-476
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Abstract

A 55yearold female with stage IVA follicular lymphoma in third complete remission underwent allogeneic peripheral blood stem cell transplantation Neutrophil engraftment was achieved on day +18 however platelet counts remained below 10 × 103/µL necessitating transfusions twice a week for more than 3 months Bone marrow showed a decreased number of megakaryocytes with hypolobulated nuclei No graft versus host disease viral infection or disease relapse was observed Furthermore severe thrombocytopenia below 50 × 103/µL refractory to transfusion appeared on day +240 after influenza virus infection Treatments with intravenous immunoglobulin romiplostim and rituximab were administered without any recovery Subsequently eltrombopag was initiated on day +443 after which platelet counts rose gradually and continued to rise above 20 × 103/µL after 10 weeks of administration The serum thrombopoietin TPO level was markedly elevated and antiTPO receptor TPOR antibody was detected in the patient’s serum AntiTPOR antibody may play an important role in some cases of prolonged thrombocytopenia after allogeneic hematopoietic stem cell transplantation with unknown etiology and eltrombopag could be a novel therapeutic option for such cases

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