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Effect of the nonpeptide thrombopoietin receptor agonist Eltrombopag on bone marrow cells from patients with acute myeloid leukemia and myelodysplastic syndrome

Thrombocytopenia is a frequent symptom and clinical challenge in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Eltrombopag is a small molecule thrombopoietin receptor agonist that might be a new option to treat thrombocytopenia in these diseases, provided that it doe...

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Published in:Blood 2009-10, Vol.114 (18), p.3899-3908
Main Authors: Will, Britta, Kawahara, Masahiro, Luciano, Julia P., Bruns, Ingmar, Parekh, Samir, Erickson-Miller, Connie L., Aivado, Manuel A., Verma, Amit, Steidl, Ulrich
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creator Will, Britta
Kawahara, Masahiro
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Steidl, Ulrich
description Thrombocytopenia is a frequent symptom and clinical challenge in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Eltrombopag is a small molecule thrombopoietin receptor agonist that might be a new option to treat thrombocytopenia in these diseases, provided that it does not stimulate malignant hematopoiesis. In this work, we studied the effects of Eltrombopag on proliferation, apoptosis, differentiation, colony formation, and malignant self-renewal of bone marrow mononuclear cells of patients with AML and MDS. Malignant bone marrow mononuclear cells did not show increased proliferation, or increased clonogenic capacity at concentrations of Eltrombopag ranging from 0.1 to 30 μg/mL. On the contrary, we observed a moderate, statistically nonsignificant (P = .18), decrease of numbers of malignant cells (mean, 56%; SD, 28%). Eltrombopag neither led to increased 5-bromo-2-deoxyuridine incorporation, decreased apoptosis, an increase of malignant self-renewal, nor enhanced in vivo engraftment in xenotransplantations. Furthermore, we found that Eltrombopag was capable of increasing megakaryocytic differentiation and formation of normal megakaryocytic colonies in patients with AML and MDS. These results provide a preclinical rationale for further testing of Eltrombopag for treatment of thrombocytopenia in AML and MDS.
doi_str_mv 10.1182/blood-2009-04-219493
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source Elsevier ScienceDirect Journals
subjects Animals
Apoptosis - drug effects
Benzoates - pharmacology
Benzoates - therapeutic use
Biological and medical sciences
Bone Marrow Cells - metabolism
Bone Marrow Cells - pathology
Cell Differentiation
Cell Proliferation - drug effects
Dose-Response Relationship, Drug
Hematologic and hematopoietic diseases
Hematopoiesis - drug effects
Humans
Hydrazines - pharmacology
Hydrazines - therapeutic use
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - metabolism
Leukemia, Myeloid, Acute - pathology
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Leukocytes, Mononuclear - metabolism
Leukocytes, Mononuclear - pathology
Male
Medical sciences
Megakaryocytes - metabolism
Megakaryocytes - pathology
Mice
Mice, Inbred NOD
Myelodysplastic Syndromes - drug therapy
Myelodysplastic Syndromes - metabolism
Myelodysplastic Syndromes - pathology
Myeloid Neoplasia
Pyrazoles - pharmacology
Pyrazoles - therapeutic use
Receptors, Thrombopoietin - agonists
Receptors, Thrombopoietin - metabolism
Thrombocytopenia - drug therapy
Thrombocytopenia - metabolism
Thrombocytopenia - pathology
Xenograft Model Antitumor Assays
title Effect of the nonpeptide thrombopoietin receptor agonist Eltrombopag on bone marrow cells from patients with acute myeloid leukemia and myelodysplastic syndrome
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