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Markedly High Plasma Thrombopoietin (TPO) Level is a Predictor of Poor Response to Immunosuppressive Therapy in Children With Acquired Severe Aplastic Anemia. | LitMetric

AI Article Synopsis

  • Immunosuppressive therapy (IST) is commonly used for children with acquired severe aplastic anemia (SAA), but responses vary widely among patients.
  • A study involving 85 children found that higher thrombopoietin (TPO) levels at diagnosis were linked to poorer responses to IST and lower long-term survival rates.
  • Measuring TPO levels before starting IST could help predict which patients are more likely to respond to treatment, aiding in clinical decision-making.

Article Abstract

Background: Immunosuppressive therapy (IST) is commonly used for patients with acquired severe aplastic anemia (SAA). Because the clinical response rate and therapeutic outcome for individual patients to IST varies, an in vitro test that identifies potential responders would be desirable.

Methods: We evaluated the relationship between thrombopoietin (TPO) levels at the time of diagnosis and the response to IST at 6 months in 85 children (median age, 9.0 years; range, 1.0-15.5 years) with acquired SAA using enzyme-linked immunosorbent assay. Thirty-one age-matched healthy individuals were used as controls. All patients received antithymocyte globulin and cyclosporine.

Results: Overall, 39 patients (45.9%) responded to IST at 6 months. TPO plasma levels were significantly higher in nonresponders than in responders (1,555.8 vs. 1,284.7 pg/ml, respectively; P = 0.031). Multivariate analysis identified the TPO levels of >1,796.7 pg/ml (TPO-high group, 20 patients; odds ratio (OR), 8.285; 95% confidence interval (CI), 2.114-32.904; P = 0.002) as independent poor predictors of IST response at 6 months. Moreover, the TPO-high group was associated with lower 5-year failure-free survival rates (30% vs. 68%, P = 0.012) compared with the TPO-low group.

Conclusion: The measurement of TPO levels at diagnosis is useful for predicting the response to IST in children with SAA and may help in decision making.

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Source
http://dx.doi.org/10.1002/pbc.25820DOI Listing

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