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Various toxicities: 6 case reports In an observational retrospective study of 77 patients, treated from April 2011 to December 2018, 6 patients including two men and one woman aged 64–92 years [not all ages and sexes stated] were described, who developed viral hepatitis B, insomnia, glucose intolerance, right cerebellar infarction, aneurysmal subarachnoid haemorrhage or worsening of abdominal aortic aneurysm during treatment with prednisolone or eltrombopag for chronic immune thrombocytopenia (ITP) [dosages not stated; not all routes, durations of treatments to reactions onsets and outcomes stated]. The patients, who had ITP, started receiving first-line therapy with prednisolone (3 patients) and oral eltrombopag (3 patients). Subsequently, the patients developed viral hepatitis B (1 patient), insomnia (1 patient) and glucose intolerance (1 patient) secondary to the prednisolone therapy. The three patients, who received eltrombopag therapy developed a right cerebellar infarction after 5 months of the initiation of eltrombopag (1 patient) and aneurysmal subarachnoid haemorrhage; an aneurysm at the right anterior cerebral artery (1 patient). The remaining one patient had a history of hypertension and presented with a 45mm abdominal aortic aneurysm, which had previously been asymptomatic. After 1.2 years of the initiation of eltrombopag therapy, follow-up CT scan showed enlargement of the aneurysm to a diameter of 58mm. Based on these findings, worsening of abdominal aortic aneurysm secondary to the eltrombopag therapy was considered in this patient. The patients, who developed viral hepatitis B and insomnia, respectively stopped prednisolone therapy and received second-line therapy with eltrombopag, while the patient, who developed glucose intolerance received additional eltrombopag and prednisolone dose was tapered. The patient (who developed right cerebellar infarction) was conservatively treated with edaravone. The patient (who developed subarachnoid haemorrhage) was treated by coil embolisation, and the patient (who developed worsening of abdominal aortic aneurysm) underwent the insertion of a stent graft. All the patients, who received eltrombopag therapy recovered without sequelae. Iino M, et al. Treatment-free remission after thrombopoietin receptor agonist discontinuation in patients with newly diagnosed immune thrombocytopenia: an observational retrospective analysis in real-world clinical practice. International Journal of Hematology 112: 159-168, No. 2, Aug 2020. Available from: URL: http://doi.org/10.1007/ 803500596 s12185-020-02893-y

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Reactions 12 Sep 2020 No. 1821