Journal of Hematology & Thromboembolic Diseases
Open Access

Abstract

Significance of Anti-GPIIb/IIIa Antibody in Efficacy of Eltrombopag for Patients with Immune Thrombocytopenia

Shosaku Nomura, Shinya Fujita, Yoshiko Azuma, Yukie Fujita, Tohru Nishizawa, Masaaki Hotta, Hideaki Yoshimura, Takahisa Nakanishi, Atsushi Satake, Aya Nakaya, Kazuyoshi Ishii and Tomoki Ito

Immune thrombocytopenia (ITP) is an acquired hemorrhagic condition of accelerated platelet consumption caused by antiplatelet autoantibodies, and glycoprotein (GP)IIb/IIIa is one of the major target antigens recognized by platelet-reactive CD4+ T cells. Patients with ITP often have few bleeding symptoms despite very low platelet counts, suggesting that ITP platelets are highly functional. Several factors may contribute to the prothrombotic state in ITP. We investigated the effect of thrombopoietin (TPO)-receptor agonist (RA) on the procoagulant state in ITP with or without anti-GPIIb/IIIa antibody. Long-term administration of eltrombopag resulted in stabilization of platelet numbers in many patients. On the other hand, when the analysis was carried out according to the presence of GPIIb/IIIa autoantibodies, the increase in platelet counts in ITP patients was more significant with than without anti-GPIIb/IIIa autoantibodies. In addition, there were significant differences in PDMP between cases in which platelet count was above or below 100x109/l. Our observation is possible to reflect the role of the anti-GPIIb/IIIa antibody in ITP patients who received TPO-RA.