Is Eltrombopag Useful in the Treatment of Children with Chronic Immune Thrombocytopenic Purpura

Background: Chronic immune thrombocytopenic purpura is an autoimmune disease.Platelet count is decreased due to antibody-mediated platelet destruction as well as suppression of platelet production.So enhancement of platelet production could be a targeted goal of treatment.Methods: This is a placebo controlled prospective study conducted in the Department of Pediatric Hematology & Oncology, Dhaka Shishu (Children) Hospital from July 2018 to June 2020.Eltrombopag was given to chronic immune thrombocytopenic children at the dose of 25-50 mg/day according to age group and monitored clinically as well as laboratorial parameters including platelet count.Results: In thirteen (65%) of 20 study children, platelet count began to rise at day 10 and reached peak level at 5 th week and all the responded children clinically improved by reduce or disappearance of bleeding manifestations.Eight (40%) responded patients maintaining platelet count for variable period while taking eltrombopag.The incidences of adverse events like headache, upper respiratory tract infections and raised transaminase (SGPT) are 10%, 10% and 15% respectively.Conclusion: It is revealed that eltrombopag increase platelet count and reduces bleeding manifestations in statistically significant proportion of chronic ITP children.No serious adverse event is seen.So eltrombopag could be use for treatment of children with chronic immune thrombocytopenic purpura.