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

María Teresa Álvarez Román; Ihosvany Fernández Bello; Elena G. Arias-Salgado; María Isabel Rivas Pollmar; Víctor Jiménez Yuste; Mónica Martín Salces; Nora V. Butta

doi:10.1160/TH13-10-0873

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2014; 112(01): 65-72
DOI: 10.1160/TH13-10-0873

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

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

María Teresa Álvarez Román

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

,

Ihosvany Fernández Bello

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

,

Elena G. Arias-Salgado

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

,

María Isabel Rivas Pollmar

²Hematology Unit, Hospital Universitario La Princesa¸ Madrid, Spain

,

Víctor Jiménez Yuste

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

³Universidad Autónoma de Madrid, Spain

,

Mónica Martín Salces

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

,

Nora V. Butta

¹Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

› Institutsangaben

Abstract

Summary

Thrombopoietin receptor agonists (TPO-RA) have recently been introduced for the treatment of immune thrombocytopenia (ITP), an antiplatelet-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.

Keywords

Thrombopoietin receptor agonists - platelets - thrombin generation - microparticle-associated procoagulant state

Volltext

Referenzen

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