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    Publication Only

    Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies

    Publication Only

    PO27 - Experience with Fostamatinib in a single center

    Wednesday, June 28, 2023
    13:00 – 14:00 ET
    Room: 10
    Background: Fostamatinib is a drug with which there is currently little experience. Fostamatinib has an indication for the treatment of chronic immune thrombocytopenia (ITP) in adults who are resistant to other lines of treatment.

    Aims: The aim is to describe our experience in treatment with Fostamatinib in patients with ITP.

    Methods: In our center we have two cases of patients in whom fostamatinib has been applied after having followed several lines of treatment without being able to maintain stable platelet numbers.

    Results: The first is a 41-year-old man ITP diagnosed in 2015. He started treatment with Ig and steroids, presenting a short-term response. Subsequently, Eltrombopag was used for 2 years, maintaining platelet counts, after which a drop in platelets, so the line was changed to Romipplostim and maintained for 2 years, ending because of musculoskeletal pain.
    The patient started Fostamatinib, has been under treatment for 5 months without presenting bleeding manifestations or side effects and with maintained platelet counts.

    The second is a 45-year-old woman with ITP diagnosed in 2011. She has undergone several lines of treatment, these being Ig and steroids with partial response and headaches to Ig. She was splenectomized in 2012, she has received treatments with Eltrombopag, Rituximab and Romiplostim presenting a poor and non-maintained response.
    The treatment line was changed to Fostamatinib, with which the patient continued to present the same oscillating sawtooth behavior without achieving stable maintenance of platelet numbers. Currently, treatment with Romiplostim has been restarted.

    Conclusion(s): In the experience of our center, although limited, we can conclude that in patients with stable platelet levels it is a useful drug but in the case of patients with oscillating levels it has not achieved better control of these, and it is probably necessary to associate it with another drug to your control. More studies are necessary to obtain further conclusions.