PMID- 32338586
OWN - NLM
STAT- MEDLINE
DCOM- 20201102
LR  - 20201102
IS  - 1607-8454 (Electronic)
IS  - 1024-5332 (Linking)
VI  - 25
IP  - 1
DP  - 2020 Dec
TI  - Disappearance of monosomy 7 in a patient with aplastic anemia after eltrombopag 
      treatment.
PG  - 165-167
LID - 10.1080/16078454.2020.1757331 [doi]
AB  - We present the case of a patient with aplastic anemia (AA) who was treated with 
      eltrombopag. To the best of our knowledge, this is the first report of the 
      disappearance of monosomy 7 after eltrombopag treatment. The patient was a 
      77-year-old woman with intraoral hematoma and purpura who was diagnosed with very 
      severe AA with a normal karyotype. After combination therapy with rabbit 
      antithymocyte globulin, cyclosporin, and granulocyte-colony-stimulating factor 
      (G-CSF), pancytopenia transiently improved. When pancytopenia worsened again, the 
      patient was administered darbepoetin alfa for renal anemia and danazol. Bone 
      marrow examination showed 2.5% blasts with the karyotype 45,XX,-7[17]/46,XX[3], 
      and 87.0% of marrow cells had monosomy 7, as determined by 7q31 interphase 
      fluorescence in situ hybridization (FISH) analysis. Pancytopenia was considered 
      owing to the evolution of myelodysplastic syndrome, and we stopped G-CSF and 
      darbepoetin treatment. As she refused treatment with a hypomethylating agent, 
      considering her age, eltrombopag was started against refractory pancytopenia 
      after obtaining informed consent. She showed an improvement in pancytopenia and 
      became transfusion independent. After 1 year of eltrombopag treatment, bone 
      marrow examination revealed 0.7% blasts with the karyotype 46,XX[20] and without 
      monosomy 7 clone by FISH analysis. After a further 1 year of eltrombopag 
      treatment with dose tapering, she has achieved a complete response. This case 
      suggested that eltrombopag treatment is not necessarily contraindicated in 
      patients with monosomy 7.
FAU - Uchibori, Yusuke
AU  - Uchibori Y
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Hangaishi, Akira
AU  - Hangaishi A
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Kamoda, Yoshimasa
AU  - Kamoda Y
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Hirao, Masako
AU  - Hirao M
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Iizuka, Hiromitsu
AU  - Iizuka H
AUID- ORCID: 0000-0002-6654-3257
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Kida, Michiko
AU  - Kida M
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
FAU - Usuki, Kensuke
AU  - Usuki K
AD  - Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Hematology
JT  - Hematology (Amsterdam, Netherlands)
JID - 9708388
RN  - 0 (Benzoates)
RN  - 0 (Hydrazines)
RN  - 0 (Pyrazoles)
RN  - S56D65XJ9G (eltrombopag)
RN  - Chromosome 7, monosomy
SB  - IM
MH  - Aged
MH  - Anemia, Aplastic/*complications
MH  - Benzoates/*adverse effects
MH  - Chromosome Deletion
MH  - Chromosomes, Human, Pair 7/drug effects
MH  - Female
MH  - Humans
MH  - Hydrazines/*adverse effects
MH  - Pyrazoles/*adverse effects
OTO - NOTNLM
OT  - Acute myeloid leukemia
OT  - Aplastic anemia
OT  - Myelodysplastic syndromes
OT  - clonal evolution
OT  - eltrombopag
OT  - monosomy 7
OT  - thrombopoietin receptor agonist
EDAT- 2020/04/28 06:00
MHDA- 2020/11/03 06:00
CRDT- 2020/04/28 06:00
PHST- 2020/04/28 06:00 [entrez]
PHST- 2020/04/28 06:00 [pubmed]
PHST- 2020/11/03 06:00 [medline]
AID - 10.1080/16078454.2020.1757331 [doi]
PST - ppublish
SO  - Hematology. 2020 Dec;25(1):165-167. doi: 10.1080/16078454.2020.1757331.