Interplay of leucocyte-platelet complexes and clinical response to eltrombopag in immune thrombocytopenia patients


Por: Osuna-Gómez, R, Zamora, C, Novelli, S, Garcia-Pallarols, F, Rodriguez, Y, Domingo, A, Canet, M, Olivera, P, Mulet, M, Cantó, E, Valcarcel, D, Sanchez-Gonzalez, B, Vidal, S

Publicada: 1 abr 2025 Ahead of Print: 1 sep 2024
Resumen:
Eltrombopag (ELT) is a thrombopoietin-receptor agonist that stimulates platelet (PLT) production in patients with primary immune thrombocytopenia (ITP). One potential mechanism of ELT is modulating the inflammatory response by increasing PLTs binding to leucocytes. This study examined the effect of ELT on leucocyte-PLTs complexes in 38 ITP patients. Patients, predominantly females with a mean age of 59 years, underwent treatments like corticosteroids, intravenous immunoglobulin and splenectomy. Compared to healthy donors, ITP patients exhibited lower percentages of lymphocyte with bound PLTs, but similar monocyte- or neutrophil with bound PLTs. ELT treatment increased PLTs counts and all types of leucocyte with bound PLTs. Network analysis showed dynamic changes in leucocyte with bound PLTs relationships due to ELT. Machine learning indicated that higher percentages of monocytes with bound PLTs were linked to a better clinical response to ELT. A possible mechanism was an increased IL-10 production in monocytes with bound PLTs from responder patients. This study provides insights into the immunological changes in ITP patients undergoing ELT and suggests potential predictive biomarkers for treatment response and disease monitoring. In the peripheral blood of immune thrombocytopenia (ITP) patients who respond to eltrombopag, the percentage of monocytes with bound platelets (PLTs) is higher compared to non-responder patients. These monocytes with bound PLT showed increased IL-10 production and higher CD16 and CD14 expression compared to monocytes without bound PLTs. This indicates better platelet recovery and a more durable response in ITP patients (created with ).image

Filiaciones:
Osuna-Gómez, R:
 Inst Recerca St Pau IR St Pau, Grp Inflammatory Dis, Barcelona, Spain

Zamora, C:
 Inst Recerca St Pau IR St Pau, Grp Inflammatory Dis, Barcelona, Spain

Novelli, S:
 Hosp Santa Creu & Sant Pau, Hematol Dept, Barcelona, Spain

Garcia-Pallarols, F:
 Hosp del Mar, Hematol Dept, Barcelona, Spain

Rodriguez, Y:
 Hosp Valle De Hebron, Hematol Dept, Barcelona, Spain

Domingo, A:
 Hosp Granollers, Hematol Dept, Granollers, Spain

Canet, M:
 Hosp Univ Mutua Terrassa, Hematol Dept, Terrassa, Spain

Olivera, P:
 Banc Sang i Teixits, Barcelona, Spain

Mulet, M:
 Inst Recerca St Pau IR St Pau, Grp Inflammatory Dis, Barcelona, Spain

Cantó, E:
 Inst Recerca St Pau IR St Pau, Grp Inflammatory Dis, Barcelona, Spain

Valcarcel, D:
 Hosp Valle De Hebron, Hematol Dept, Barcelona, Spain

Sanchez-Gonzalez, B:
 Hosp del Mar, Hematol Dept, Barcelona, Spain

Vidal, S:
 Inst Recerca St Pau IR St Pau, Grp Inflammatory Dis, Barcelona, Spain
ISSN: 00071048





BRITISH JOURNAL OF HAEMATOLOGY
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Reino Unido
Tipo de documento: Article
Volumen: 206 Número: 4
Páginas: 1200-1212
WOS Id: 001320053000001
ID de PubMed: 39327831
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