NPlate for SAA

[Snuuze]

Hi, All,

I've been around the block the past year with diagnoses of MDS, PNH and now SAA. Because my BMB shows that I am producing no platelets, my doctor would like me to begin NPlate. I've been browsing through the forums (thank you, everyone, for your inputs) I can't find much about success with NPlate for those of us in the MDS grouping. I get a little nervous reading the data that says don't use for MDS. Any comments or suggestions of where to look?

At the moment I receive platelet transfusions every 10 days or so when platelet count goes to 10 or lower. Other transfusions are every 2 weeks, when HGB gets to 8 or lower. I've got bruises that would suggest I fell off a truck but no bleeding. Current drug regimen is Aranesp biweekly, Soliris biweekly and Cyclosporine (hate the side effects) twice a day.

[Sally C]

Hey Snuuze,
My husband has been red/platelet transfusion dependent since 1/09. I don't have any input regarding Nplate but he is in a clinical trial at NIH for Promacta (Eltrombopag). They had such good success with their AA patients they decided to try it with their MDS patients which is what Don has. It has been about 10 weeks since his last platelet transfusion. He's not setting the world on fire with his platelet count (22,000 today) but he is staying well above where he would need a transfusion. He has tolerated the medication well. I don't know how close the 2 meds are but maybe it's a question you can ask your doctor.
Best of luck to you!
Sally

[Snuuze]

Thank you, Sally, for the information. There is alot more available data about Promacta than Nplate. I'll certainly ask the doctor when I talk to her.

Sue

[Birgitta-A]

Hi Snuuze,
Here is an abstract about Nplate (Romiplostim) in MDS patients.
"The proportion of pts experiencing a significant bleeding event decreased from 23% during weeks 1–12 to 0% during weeks 48–60. Similarly, the proportion of pts receiving a platelet transfusion decreased from 28% during weeks 1–12 to 0% during weeks 48–60. 85% had a platelet response. The median duration of platelet response was 41 weeks (15–87 weeks)."

"Peripheral blasts were increased in 2 pts (MDS-U and RA at baseline) and resolved in both cases after discontinuation of romiplostim. Three cases of progression to AML were reported, corresponding to an annual on-study event rate of 5.9%."

http://cancercaresouthtexas.com/docu..._Safety_an.pdf

I am still waiting for results from studies about Promacta in MDS patients - we can hope that Promacta won't increase blast cells but we know that both drugs can increase bone marrow fibrosis. Still MDS patients in this forum report good results from both drugs.
Kind regards
Birgitta-A