Bước đầu đánh giá hiệu quả điều trị của Eltrombopag trên người bệnh giảm tiểu cầu miễn dịch người lớn dai dẳng và mạn tính tại Bệnh viện Truyền máu Huyết học

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Tác giả: Thị Lộc Cao, Thị Mỹ Liên Kiều, Oanh Thùy Linh Nguyễn, Quốc Tuấn Trần, Thùy Dương Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại: 612.11822 Blood and circulation

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 402-409

Bộ sưu tập: Metadata

ID: 500809

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Đánh giá hiệu quả điều trị của eltrombopag trên người bệnh giảm tiểu cầu miễn dịch người lớn dai dẳng và mạn tính tại bệnh viện truyền máu huyết học Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả loạt ca, hồi cứu hồ sơ ghi nhận các thông tin lâm sàng, cận lâm sàng và kết cục điều trị, biến chứng điều trị từ tháng 1/2018 tới tháng 12/2021 Kết quả: Nghiên cứu trên 21 bệnh nhân, độ tuổi trung bình 38,1, với nữ ưu thế hơn nam. 9/21 bệnh nhân ở giai đoạn dai dẳng, 13 bệnh nhân đã chuyển sang giai đoạn mạn tính. Xuất huyết xảy ra ở 19/21 (90.1%) bệnh nhân trước điều trị eltrombopag, hầu hết bệnh nhân xuất huyết độ I theo WHO (73,7%). Hầu hết bệnh nhân (16) được khởi đầu điều trị với liều thấp (25mg), kết hợp với corticoid ở 14/21 (66,7%) bệnh nhân. 85,7% (18 bệnh nhân) trong nghiên cứu có ít nhất một đáp ứng về tiểu cầu (được định nghĩa là lớn hơn 50 x 109/L mà không có kèm theo liệu pháp cứu vớt và/hoặc cắt lách). Gần một nửa bệnh nhân đạt đáp ứng tiểu cầu trên 50 x 109/L ở tuần thứ 4 vẫn giữ được đáp ứng tiểu cầu cho tới tuần thứ 28 mà không cần liệu pháp cứu vớt. 7/21 bệnh nhân ghi nhận biến chứng trong quá trình uống eltrombopag, thường gặp là tăng men gan nhẹ (n=3). Ngoài ra có các triệu chứng khác như đau nhức người (n=2), mệt mỏi (n=2), đau đầu (n=2), buồn nôn (n=1), khô da (n=1). Kết luận: Eltrombopag hiệu quả trong điều trị ITP dai dẳng, mạn tính. Những lợi ích này nên được cân bằng với những tác dụng không mong muốn trong điều trị Eltrombopag.To evaluate the effectiveness of eltrombopag in aldult chronic/persistent immune thrombocytopenia at Blood Transfusion Hospital Subjects and Methods: This was a descriptive case series study. We retrospectively reviewed the medical recorded records clinical, laboratory test, the response and outcome of treatment and side effects of eltrombopag from January 2018 to December 2021 Results: 21 patients were included in this study, average age was 38,1 year-old, with female predominance over male. 9/21 patients were in the persistent stage, 13 patients had progressed to the chronic stage. Bleeding symptoms occurred in 19 (90,1%) of 21 patients at baseline, 14 patients (73,7%) reported WHO grade 1 bleeding. Most patients (16) were initiated on a low dose (25 mg), in combination with corticosteroids, in 14/21 (66.7%) patients. 85.7% (18 patients) achieved a response (platelet count ≥ 50 x 109/L at least once in the absence of rescue and/or splenectomy). Nearly half of the patients who achieved a platelet response above 50 x 109/L at week 4 maintained a platelet response up to week 28 without salvage therapy. 7/21 patients reported adverse events, including mild elevation of liver enzymes (n=3), body aches (n=2), fatigue (n=2), headache (n=2), nausea (n=1), dry skin (n=1). Conclusion: Eltrombopag is effective for management of chronic/persistent immune thrombocytopenia. These benefits should be balanced with the potential risks associated with eltrombopag treatment.

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