High pretreatment peripheral blood T‐cell receptor clonality as a predictor of prolonged response in immune thrombocytopenia
Left panel: Scheme of the XPAG-immune thrombocytopenia trial. The dexamethasone (DEX) arm consisted of DEX 40 mg/day for days 1-4 for one to three cycles every 28 days to a maximum of 12 weeks, cycles 2 + 3 were optional. Patients randomised to eltrombopag (ETB) + DEX received eltrombopag in combination with a short course of high-dose DEX beginning on day 1 (40 mg/day during days 1-4). The starting dose of ETB was 50 mg/day for 2 weeks; thereafter, the ETB dose was increased by 25 mg for all patients who did not achieve the target platelet count of ≥50 × 10<sup>9</sup>/L. The ETB tapering was performed by decreasing the dose by 25 mg every 2 weeks to a minimum dose of 25 mg every other day for all patients. Right upper panel: Clinical outcomes in patients treated with first-line ETB + DEX. Patients displayed a qualitatively longer response duration and qualitatively reduced usage of rescue medication. Right lower panel: The immunological T-cell response was different in treatment responders and non-responders. Patients with sustained response (responders) displayed a high T-cell clonality at baseline. Clones are depicted as bubbles (right side).
Authors
- Jakob Robert Passweg (ORCID: https://orcid.org/0000-0001-7092-3351)
- Tamara Tesanovic
- Thomas Stauch (ORCID: https://orcid.org/0000-0002-1622-4901)
- Claudia Quiering
- Roland Repp
- Axel Matzdorff
- Karolin Trautmann‐Grill (ORCID: https://orcid.org/0000-0002-9050-1049)
- Donjetë Simnica (ORCID: https://orcid.org/0000-0003-2286-1381)
- Martina Stauch
- Christoph Schultheiß (ORCID: https://orcid.org/0000-0001-9789-5776)
- Clemens Schulte (ORCID: https://orcid.org/0000-0003-2362-3318)
- Oliver Meyer (ORCID: https://orcid.org/0000-0002-3002-333X)
- Andreas Holbro (ORCID: https://orcid.org/0000-0002-2394-2223)
- Mathias Hänel (ORCID: https://orcid.org/0000-0002-4767-3275)
- Annaïse Jauch
- Mathias Rummel (ORCID: https://orcid.org/0000-0002-9278-2171)
- Gerda Silling
- Bastian Fleischmann
- Mascha Binder (ORCID: https://orcid.org/0000-0003-0663-3004)
- Jörg Chromik
- Manfred Welslau
- Paul Schmidt‐Barbo
- Frank Richter
- Sabine Jahn
- Falk Nimmerjahn
Institutions
- Goethe University Frankfurt (DE)
- NHS Blood and Transplant (GB)
- University of Freiburg (DE)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Justus-Liebig-Universität Gießen (DE)
- University Hospital of Basel (CH)
- Novartis (Germany) (DE)
- Städtisches Klinikum Dresden (DE)
- Klinikum Aschaffenburg (DE)
- Department of Biomedicine Basel (CH)
- University Hospital Frankfurt (DE)
- Jena University Hospital (DE)
- Klinik Donaustauf (DE)
- Praxis für Hämatologie und Onkologie (DE)
- Aschaffenburg University of Applied Sciences (DE)
- Asklepios (DE)
- University Hospital Carl Gustav Carus (DE)
- Klinikum Chemnitz (DE)
- Clinical Research Center Kiel (DE)
- Hochschule für Technik und Wirtschaft Dresden – University of Applied Sciences (DE)
- Technische Universität Dresden (DE)
- Ludwig-Maximilians-Universität München (DE)
- RWTH Aachen University (DE)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2026-01-04
- DOI
- https://doi.org/10.1111/bjh.70310
- Citations
- 1
- Primary Topic
- Platelet Disorders and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 35.41