Successful switching from eltrombopag to romiplostim in a pediatric patient with refractory chronic ITP.

Abstract

Herein, we report a successful treatment experience with romiplostim in a child with immune thrombocytopenia (ITP) refractory to eltrombopag. A 9-year-old female developed chronic ITP, which was refractory to standard treatments, including intravenous immunoglobulin, cepharanthine and splenectomy, and she thus became dependent on prednisolone (PSL). At age 12 years, eltrombopag was started, but failed to increase her platelet count. Another thrombopoietin receptor agonist (TPO-RA), romiplostim, possibly having a different mechanism of action, was then administered. Platelet counts increased and PSL could thus be terminated. Our case suggests TPO-RA alteration to potentially be effective for chronic refractory ITP.