| Title |
Pathophysiology and management of thrombocytopenia in bone marrow failure: possible clinical applications of TPO receptor agonists in aplastic anemia and myelodysplastic syndromes
|
|---|---|
| Published in |
International Journal of Hematology, May 2013
|
| DOI | 10.1007/s12185-013-1352-6 |
| Pubmed ID | |
| Authors |
Danielle M. Townsley, Ronan Desmond, Cynthia E. Dunbar, Neal S. Young |
| Abstract |
Aplastic anemia is a bone marrow failure syndrome that causes pancytopenia and can lead to life-threatening complications. Bone marrow transplantation remains the standard of care for younger patients and those with a good performance status but many patients may not have a suitable donor. Immunosuppressive therapy is able to resolve cytopenias in a majority of patients with aplastic anemia but relapses are not uncommon and some patients remain refractory to this approach. Patients may require frequent blood and platelet transfusion support which is expensive and inconvenient. Life-threatening bleeding complications still occur despite prophylactic platelet transfusion. Thrombopoietin (TPO) mimetics, such as romiplostim and eltrombopag, were developed to treat patients with refractory immune thrombocytopenia but are now being investigated for the treatment of bone marrow failure syndromes. TPO is the main regulator for platelet production and its receptor (c-Mpl) is present on megakaryocytes and hematopoietic stem cells. Trilineage hematopoietic responses were observed in a recent clinical trial using eltrombopag in patients with severe aplastic anemia refractory to immunosuppression suggesting that these agents can provide a new therapeutic option for enhancing blood production. In this review, we discuss these recent results and ongoing investigation of TPO mimetics for aplastic anemia and other bone marrow failure states like myelodysplastic syndromes. Clonal evolution or progression to acute myeloid leukemia remains a concern when using these drugs in bone marrow failure and patients should only be treated in the setting of a clinical trial. |
Mendeley readers
The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | 1% |
| United States | 1 | 1% |
| Italy | 1 | 1% |
| Unknown | 80 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 13 | 16% |
| Researcher | 12 | 14% |
| Student > Postgraduate | 9 | 11% |
| Student > Master | 8 | 10% |
| Student > Ph. D. Student | 7 | 8% |
| Other | 18 | 22% |
| Unknown | 16 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 42 | 51% |
| Biochemistry, Genetics and Molecular Biology | 4 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
| Agricultural and Biological Sciences | 3 | 4% |
| Psychology | 3 | 4% |
| Other | 8 | 10% |
| Unknown | 20 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 March 2016.
All research outputs
#6,403,199
of 22,747,498 outputs
Outputs from International Journal of Hematology
#203
of 1,388 outputs
Outputs of similar age
#54,255
of 195,583 outputs
Outputs of similar age from International Journal of Hematology
#5
of 17 outputs
Altmetric has tracked 22,747,498 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 1,388 research outputs from this source. They receive a mean Attention Score of 3.6. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 195,583 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.