艾曲泊帕在免疫性血小板减少症、再生障碍性贫血和骨髓增生异常综合征中的应用进展

Application advances of Eltrombopag in immune thrombocytopenia,aplastic anemia and myelodysplastic syndrome

艾曲泊帕不仅可促进巨核细胞分化,还对造血干细胞具有刺激作用,从而有效治疗免疫性血小板减少症(ITP)、再生障碍性贫血(AA)和骨髓增生异常综合征(MDS)。艾曲泊帕在ITP、AA和MDS中的疗效存在差异,可能与三种疾病残存的正常造血功能不同有关。三种疾病存在共同的免疫病理机制以及疾病间转化的可能性。艾曲泊帕的免疫调节和铁动员作用可能有助于改善造血。本文分析了艾曲泊帕在ITP、AA和MDS中的最新研究,探索各研究中药物不同剂量、联合治疗以及停药的依据。

Beyond the effect on megakaryopoiesis, Eltrombopag also shows a stimulating effect on hematopoietic stem cells, accounting for its efficacy in immune thrombocytopenia(ITP), aplastic anemia(AA) and myelodysplastic syndrome(MDS). The distinct efficacy in ITP, AA and MDS reflects the different residual normal hematopoiesis in the three diseases, which possess common immune-pathological mechanisms and a possible evolution of one condition into the other. Eltrombopag exerts immunomodulating activity and iron-mobilizing effects that may contribute to improving hematopoiesis. This article analyzes the latest studies of Eltrombopag in ITP, AA, and MDS, and explores the basis for different doses, combination therapy, and discontinuation of drugs in each context.