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Soyer N, Ali R, Turgut M, Haznedaroğlu İC, Yılmaz F, Aydoğdu İ, Pir A, Karakuş V, Özgür G, Kiş C, Ceran F, İlhan G, Özkan M, Aslaner M, İnce İ, Yavaşoğlu İ, Gediz F, Sönmez M, Güvenç B, Özet G, Kaya E, Vural F, Şahin F, Töbü M, Durusoy R, Saydam G. Efficacy and safety of ruxolitinib in patients with myelofibrosis: a retrospective and multicenter experience in Turkey. Turk J Med Sci 2021; 51:1033-1042. [PMID: 33315343 PMCID: PMC8283435 DOI: 10.3906/sag-1812-70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 12/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background/aim The aim of this study is to assess the efficacy and safety of ruxolitinib in patients with myelofibrosis. Materials and methods From 15 centers, 176 patients (53.4% male, 46.6% female) were retrospectively evaluated. Results The median age at ruxolitinib initiation was 62 (28–87) and 100 (56.8%) of all were diagnosed as PMF. Constitutional symptoms were observed in 84.7%. The median initiation dose of ruxolitinib was 30 mg (10–40). Dose change was made in 69 (39.2%) patients. Forty seven (35.6%) and 20 (15.2%) of 132 patients had hematological and nonhematological adverse events, respectively. The mean spleen sizes before and after ruxolitinib treatment were 219.67 ± 46.79 mm versus 199.49 ± 40.95 mm, respectively (p < 0.001). There was no correlation between baseline features and subsequent spleen response. Overall survival at 1-year was 89.5% and the median follow up was 10 (1–55) months. We could not show any relationship between survival and reduction in spleen size (p = 0.73). Conclusion We found ruxolitinib to be safe, well tolerated, and effective in real-life clinical practice in Turkey. Ruxolitinib dose titration can provide better responses in terms of not only clinical benefit but also for long term of ruxolitinib treatment.
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Affiliation(s)
- Nur Soyer
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Rıdvan Ali
- Department of Hematology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Mehmet Turgut
- Department of Hematology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | | | - Fergün Yılmaz
- Department of Hematology, Atatürk Research and Training Hospital, İzmir, Turkey
| | - İsmet Aydoğdu
- Department of Hematology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Ali Pir
- Department of Hematology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Volkan Karakuş
- Department of Hematology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Gökhan Özgür
- Department of Hematology, Gülhane Research and Training Hospital, Ankara, Turkey
| | - Cem Kiş
- Department of Hematology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Funda Ceran
- Department of Hematology, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Gül İlhan
- Department of Hematology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Melda Özkan
- Department of Hematology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Müzeyyen Aslaner
- Department of Hematology, Dr. Ersin Arslan Research and Training Hospital, Gaziantep, Turkey
| | - İdris İnce
- Department of Hematology, Dr. Ersin Arslan Research and Training Hospital, Gaziantep, Turkey
| | - İrfan Yavaşoğlu
- Department of Hematology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Füsun Gediz
- Department of Hematology, Atatürk Research and Training Hospital, İzmir, Turkey
| | - Mehmet Sönmez
- Department of Hematology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Birol Güvenç
- Department of Hematology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Gülsüm Özet
- Department of Hematology, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Emin Kaya
- Department of Hematology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Filiz Vural
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Fahri Şahin
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Mahmut Töbü
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Raika Durusoy
- Department of Public Health, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Güray Saydam
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
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2
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Çekdemir D, Güvenç S, Özdemirkıran F, Eser A, Toptaş T, Özkocaman V, Haydaroğlu Şahin H, Ermiş Turak E, Esen R, Cömert M, Sadri S, Aslaner M, Uncu Ulu B, Karakuş A, Bapur DS, Alacacıoğlu İ, Aydın D, Tekinalp A, Namdaroğlu S, Ceran F, Tarkun P, Kiper D, Çetiner M, Yenerel M, Demir AM, Yılmaz G, Terzi H, Atilla E, Malkan ÜY, Acar K, Öztürk E, Tombak A, Sunu C, Salim O, Alayvaz N, Sayan Ö, Ozan Ü, Ayer M, Gökgöz Z, Andıç N, Kızılkılıç E, Noyan F, Özen M, Pepedil Tanrıkulu F, Alanoğlu G, Özkan HA, Aslan V, Çetin G, Akyol Erikçi A, Deveci B, Ersoy Dursun F, Dermenci H, Aytan P, Gündüz M, Karakuş V, Özlü C, Demircioğlu S, Akay Yanar OM, Özatlı D, Ündar L, Tiftik EN, Türköz Sucak AG, Haznedaroğlu İ, Özcan M, Şencan M, Tombuloğlu M, Özet G, Bilgir O, Turgut B, Özcan MA, Payzın KB, Sönmez M, Ayyıldız O, Dal MS, Ertop Ş, Turgut M, Soysal T, Kaya E, Ünal A, Pehlivan M, Atagündüz I, Tuğlular Fıratlı T, Saydam G, Diz Küçükkaya R. A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience. Turk J Haematol 2019; 36. [PMID: 31327186 PMCID: PMC6863031 DOI: 10.4274/tjh.galenos.2018.0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). MATERIALS AND METHODS A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. RESULTS The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). CONCLUSION Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
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Affiliation(s)
- Demet Çekdemir
- Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey,* Address for Correspondence: Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey Phone: +90 542 484 87 47 E-mail:
| | - Serkan Güvenç
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Füsun Özdemirkıran
- İzmir Atatürk Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Ali Eser
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tayfur Toptaş
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vildan Özkocaman
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Handan Haydaroğlu Şahin
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Esra Ermiş Turak
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Ramazan Esen
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Melda Cömert
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Sevil Sadri
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Müzeyyen Aslaner
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Bahar Uncu Ulu
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Derya Selim Bapur
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Demet Aydın
- Okmeydanı Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Atakan Tekinalp
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Sinem Namdaroğlu
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Funda Ceran
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Pınar Tarkun
- Kocaeli University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kocaeli, Turkey
| | - Demet Kiper
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Mustafa Çetiner
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mustafa Yenerel
- İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ahmet Muzaffer Demir
- Trakya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Edirne, Turkey
| | - Güven Yılmaz
- Dr. Lütfi Kırdar Kartal Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Erden Atilla
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Kadir Acar
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Erman Öztürk
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Anıl Tombak
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Cenk Sunu
- Sakarya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey
| | - Ozan Salim
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Nevin Alayvaz
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Özkan Sayan
- Medicana Çamlıca Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Ülkü Ozan
- Medical Park Hospital, Clinic of Hematology, Bursa, Turkey
| | - Mesut Ayer
- Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Zafer Gökgöz
- Medicana International Ankara Hospital, Clinic of Hematology, Ankara, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Ebru Kızılkılıç
- Acıbadem Kozyatağı Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Figen Noyan
- Başkent University İstanbul Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mehmet Özen
- Tokat Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tokat, Turkey
| | | | - Güçhan Alanoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Isparta, Turkey
| | - Hasan Atilla Özkan
- Yeditepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vahap Aslan
- Ümit Hospital, Clinic of Hematology, Eskişehir, Turkey
| | - Güven Çetin
- Bezmialem Vakıf University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Alev Akyol Erikçi
- İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Burak Deveci
- Medstar Antalya Hospital, Clinic of Hematology, Antalya, Turkey
| | - Fadime Ersoy Dursun
- Göztepe Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hasan Dermenci
- Haydarpaşa Numune Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Pelin Aytan
- Başkent University Training and Research Hospital, Bone Marrow and Stem Cell Transplantation Center, Department of Hematology, Adana, Turkey
| | - Mehmet Gündüz
- Atatürk Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Volkan Karakuş
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Hematology, Muğla, Turkey
| | - Can Özlü
- Ministry of Health Erzurum Regional Training and Research Hospital, Clinic of Hematology, Erzurum, Turkey
| | - Sinan Demircioğlu
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Olga Meltem Akay Yanar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Düzgün Özatlı
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Levent Ündar
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Eyüp Naci Tiftik
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Ayhan Gülsan Türköz Sucak
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - İbrahim Haznedaroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Mehmet Şencan
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Murat Tombuloğlu
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Gülsüm Özet
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Oktay Bilgir
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Burhan Turgut
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Kadriye Bahriye Payzın
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Mehmet Sönmez
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Mehmet Sinan Dal
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Şehmus Ertop
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Emin Kaya
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Mustafa Pehlivan
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Işık Atagündüz
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tülin Tuğlular Fıratlı
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Science Faculty, Department of Molecular Biology and Genetics, İstanbul, Turkey
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3
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Çekdemir D, Güvenç S, Özdemirkıran F, Eser A, Toptaş T, Özkocaman V, Haydaroğlu Şahin H, Ermiş Turak E, Esen R, Cömert M, Sadri S, Aslaner M, Uncu Ulu B, Karakuş A, Selim Bapur D, Alacacıoğlu İ, Aydın D, Tekinalp A, Namdaroğlu S, Ceran F, Tarkun P, Kiper D, Çetiner M, Yenerel M, Demir AM, Yılmaz G, Terzi H, Atilla E, Malkan ÜY, Acar K, Öztürk E, Tombak A, Sunu C, Salim O, Alayvaz N, Sayan Ö, Ozan Ü, Ayer M, Gökgöz Z, Andıç N, Kızılkılıç E, Noyan F, Özen M, Pepedil Tanrıkulu F, Alanoğlu G, Özkan HA, Aslan V, Çetin G, Akyol Erikçi A, Deveci B, Ersoy Dursun F, Dermenci H, Aytan P, Gündüz M, Karakuş V, Özlü C, Demircioğlu S, Akay Yanar OM, Özatlı D, Ündar L, Tiftik EN, Türköz Sucak AG, Haznedaroğlu İ, Özcan M, Şencan M, Tombuloğlu M, Özet G, Bilgir O, Turgut B, Özcan MA, Payzın KB, Sönmez M, Ayyıldız O, Dal MS, Ertop Ş, Turgut M, Soysal T, Kaya E, Ünal A, Pehlivan M, Atagündüz I, Tuğlular Fıratlı T, Saydam G, Diz Küçükkaya R. A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience. Turk J Haematol 2019; 36:230-237. [PMID: 31327186 DOI: 10.4274/tjh.galenos.2019.2018.0307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
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Affiliation(s)
- Demet Çekdemir
- Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey
| | - Serkan Güvenç
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Füsun Özdemirkıran
- İzmir Atatürk Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Ali Eser
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tayfur Toptaş
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vildan Özkocaman
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Handan Haydaroğlu Şahin
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Esra Ermiş Turak
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Ramazan Esen
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Melda Cömert
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Sevil Sadri
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Müzeyyen Aslaner
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Bahar Uncu Ulu
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Derya Selim Bapur
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Demet Aydın
- Okmeydanı Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Atakan Tekinalp
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Sinem Namdaroğlu
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Funda Ceran
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Pınar Tarkun
- Kocaeli University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kocaeli, Turkey
| | - Demet Kiper
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Mustafa Çetiner
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mustafa Yenerel
- İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ahmet Muzaffer Demir
- Trakya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Edirne, Turkey
| | - Güven Yılmaz
- Dr. Lütfi Kırdar Kartal Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Erden Atilla
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Kadir Acar
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Erman Öztürk
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Anıl Tombak
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Cenk Sunu
- Sakarya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey
| | - Ozan Salim
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Nevin Alayvaz
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Özkan Sayan
- Medicana Çamlıca Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Ülkü Ozan
- Medical Park Hospital, Clinic of Hematology, Bursa, Turkey
| | - Mesut Ayer
- Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Zafer Gökgöz
- Medicana International Ankara Hospital, Clinic of Hematology, Ankara, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Ebru Kızılkılıç
- Acıbadem Kozyatağı Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Figen Noyan
- Başkent University İstanbul Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mehmet Özen
- Tokat Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tokat, Turkey
| | | | - Güçhan Alanoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Isparta, Turkey
| | - Hasan Atilla Özkan
- Yeditepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vahap Aslan
- Ümit Hospital, Clinic of Hematology, Eskişehir, Turkey
| | - Güven Çetin
- Bezmialem Vakıf University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Alev Akyol Erikçi
- İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Burak Deveci
- Medstar Antalya Hospital, Clinic of Hematology, Antalya, Turkey
| | - Fadime Ersoy Dursun
- Göztepe Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hasan Dermenci
- Haydarpaşa Numune Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Pelin Aytan
- Başkent University Training and Research Hospital, Bone Marrow and Stem Cell Transplantation Center, Department of Hematology, Adana, Turkey
| | - Mehmet Gündüz
- Atatürk Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Volkan Karakuş
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Hematology, Muğla, Turkey
| | - Can Özlü
- Ministry of Health Erzurum Regional Training and Research Hospital, Clinic of Hematology, Erzurum, Turkey
| | - Sinan Demircioğlu
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Olga Meltem Akay Yanar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Düzgün Özatlı
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Levent Ündar
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Eyüp Naci Tiftik
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Ayhan Gülsan Türköz Sucak
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - İbrahim Haznedaroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Mehmet Şencan
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Murat Tombuloğlu
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Gülsüm Özet
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Oktay Bilgir
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Burhan Turgut
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Kadriye Bahriye Payzın
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Mehmet Sönmez
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Mehmet Sinan Dal
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Şehmus Ertop
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Emin Kaya
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Mustafa Pehlivan
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Işık Atagündüz
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tülin Tuğlular Fıratlı
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Science Faculty, Department of Molecular Biology and Genetics, İstanbul, Turkey
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Ertop Ş, Aslaner M, Güneş G, Malkan Ü, Tekin İ. PP-045 DEVELOPMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA IN A PATIENT WITH JAK2V617F POSITIVE ESSENTIALTHROMBOCYTHEMIA. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Aslaner M, Toka B, Ergen S, Tekin I, Ertop I. PP-041 CD5(–) MANTLE CELL LYMPHOMA: A CASE REPORT. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Aslaner M, Ustundag Y, Aslan C, Ergen S, Tekin I, Ertop I. PP-042 A CASE OF HEPATOCELLULAR CARCINOMA ACCOMPANIED BY CASTLEMAN'S DISEASE. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ergen S, Aslaner M, Ertop I, Engin H, Ozdemir M. PP-089 METASTASIS OF BREAST CANCER IN BONE MARROW WITH LEUKOERYTHROBLASTIC REACTION: A CASE REPORT. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70143-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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