Study of the immunomodulatory effect of eltrombopag in children with persistent and chronic immune thrombocytopenia

Background An important function of cluster of differentiation (CD4) T-helper cells in tolerance maintenance is the suppression of various cell types of activation and proliferation, both directly and indirectly. Aim This work aimed to evaluate the possible immunomodulatory effect of eltrombopag treatment on patients with persistent and chronic immune thrombocytopenic purpura (ITP). Patients and Methods This prospective cohort study involved 25 children, aged from 2 to 10 years, both sexes, with persistent or chronic immune thrombocytopenia, failed response to first-line therapy, and treated by eltrombopag. All patients were subjected to an assessment of CD4 before and after eltrombopag. Results CD4 counts tended to increase after eltrombopag therapy, which was statistically insignificant. There was a significant positive correlation between the CD (∆ CD4) changes, meaning CD4 increases after eltrombopag. CD4 tended to increase in a higher percentage of female patients. CD4 tended non-significantly to decrease after the intervention at a higher rate in the previously treated with Prednisone, high-dose dexamethasone, and intravenous immunoglobulin compared with the other two groups of previous treatment. Conclusion Eltrombopag may have an immunomodulatory effect in ITP patients. The levels of CD4 + were significantly lower in children with persistent and chronic ITP.