Thromb Haemost 2014; 112(01): 65-72
DOI: 10.1160/TH13-10-0873
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Effects of thrombopoietin receptor agonists on procoagulant state in patients with immune thrombocytopenia

María Teresa Álvarez Román
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
,
Ihosvany Fernández Bello
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
,
Elena G. Arias-Salgado
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
,
María Isabel Rivas Pollmar
2   Hematology Unit, Hospital Universitario La Princesa¸ Madrid, Spain
,
Víctor Jiménez Yuste
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
3   Universidad Autónoma de Madrid, Spain
,
Mónica Martín Salces
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
,
Nora V. Butta
1   Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
› Author Affiliations
Financial support: This work was supported by grants from Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación-Fondo Europeo de Desarrollo Regional (Feder) PS09/00531 (NVB) and PI12/01831.
Further Information

Publication History

Received: 26 October 2013

Accepted after minor revision: 24 January 2014

Publication Date:
01 December 2017 (online)

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Summary

Thrombopoietin receptor agonists (TPO-RA) have recently been introduced for the treatment of immune thrombocytopenia (ITP), an antiplatelet-antibodies autoimmune disease. The observation of a low frequency of bleeding episodes despite their thrombocytopenia suggests the existence of a compensatory mechanism. This study aimed to evaluate the effect of TPO-RA treatment on platelet function and on the procoagulant state in ITP patients before (ITP-bR) and after responding (ITP-aR) to treatment. Plasma- and microparticle (MP)-associated procoagulant capacity from ITP patients was similar before and after responding to the TPO-RA regimen but higher than the healthy control values. High MP-associated procoagulant activity did not seem to be due to increased platelet activation, since platelet stimulation by agonists was reduced in ITP-bR and ITP-aR patients. It could be related to increased platelet apoptosis, evaluated in terms of surface phosphatidylserine (PS), observed in both ITP groups. In summary, TPO-RA treatment increased platelet count but did not ameliorate their function and did not change plasma- and MP-associated procoagulant state of ITP patient responders to this therapy.