A case report of elderly patient with refractory severe aplastic anemia by treatment of avatrombopag in combination with tacrolimus
- VernacularTitle:阿伐曲泊帕联合他克莫司治疗老年难治性重型再生障碍性贫血1例报告
- Author:
Baozhi FANG
1
;
Yifei ZHOU
;
Qiudan SHEN
;
Muzhi YUAN
;
Xiao YU
;
Peng WANG
;
Ming'en LYU
Author Information
- Keywords: refractory aplastic anemia; elderly patients; avatrombopag; tacrolimus; eltrom-bopag
- From: Journal of Clinical Medicine in Practice 2024;28(3):105-108
- CountryChina
- Language:Chinese
- Abstract: Objective To summarize the clinical effect and adverse reactions of avatrombopag combined with tacrolimus in the treatment of elderly patient with refractory severe aplastic anemia.Methods An elderly patient with refractory severe aplastic anemia was treated with avatrombopag and tacrolimus,and the literature review on the mechanism of action and safety of avatrombopag and ta-crolimus was conducted.Results The patient was treated with a combination of cyclosporine,testos-terone undecanoate,and itraconazole for 6 months without success,and developed liver and kidney dysfunction.The medication was discontinued,and the patient was treated with a combination of avatrombopag(20 mg,once per day)and tacrolimus(1 mg,twice per day).After 9 months of treat-ment,the patient's platelet count increased to 54 × 109/L,the hemoglobin increased to 124 g/L,the white blood cells increased to 8.23 × 109/L,liver and kidney function also returned to normal level,and no other adverse reactions such as thrombotic events were observed.After treatment,CD4/CD8 de-creased,CD8+T cells increased,and the proportion of Treg cells increased as well.Conclusion The combination of avatrombopag and tacrolimus is effective and well tolerated in the treatment of elderly patient with refractory aplastic anemia,but the long-term follow-up observation and continued accumu-lation of cases are still needed in the future.
