Letter to the Editor

Split Viewer

Blood Res 2019; 54(1):

Published online March 31, 2019

https://doi.org/10.5045/br.2019.54.1.74

© The Korean Society of Hematology

A case of immune thrombocytopenia associated with invasive thymoma successfully treated with eltrombopag

Jung-Ki Yoon1,2,#, Hee Ryeong Jang3,#, Jin Hyun Park1, Ki Hwan Kim1, Eu Youn Roh4, and Ja Min Byun1,2*

1Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.

2Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

3Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea.

4Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.

Correspondence to : Ja Min Byun. Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramaero-5-gil, Dongjak-gu, Seoul 07061, Korea. jaminbyun@naver.com

Received: July 9, 2018; Revised: August 30, 2018; Accepted: October 12, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1.

Chest computed tomography (A) at diagnosis, (B) after three cycles of CAP, and (C) six months after completion of chemotherapy.


Fig. 2.

(A) Picture of bone marrow at diagnosis. The section shows normocellular marrow without malignant tumor cells (H&E stain, ×400). (B) Second bone marrow examination was performed before the third cycle of chemotherapy. The section (H&E stain, ×400) showed nearly normal distribution of nucleated cells without infiltrative tumor cells. (C) Final bone marrow examination was performed before administration of eltrombopag. The section (H&E stain, ×400) shows normocellular marrow with slightly increased megakaryocytes (right side).


Fig. 3.

Treatment course and serial platelet counts.


  1. Hoffacker V, Schultz A, Tiesinga JJ, et al. Thymomas alter the T-cell subset composition in the blood: a potential mechanism for thymoma-associated autoimmune disease. Blood 2000;96:3872-3879.
    Pubmed
  2. Rivoisy C, Besse B, Girard N, et al. Thymic epithelial tumor-associated cytopenia: a 10-year observational study in France. J Thorac Oncol 2016;11:391-399.
    Pubmed
  3. Qin J, Liu L. Thymoma with idiopathic thrombocytopenic purpura: report of a case. J Thorac Cardiovasc Surg 2005;129:453.
    Pubmed
  4. Onuki T, Kiyoki Y, Ueda S, Yamaoka M, Shimizu S, Inagaki M. Invasive thymoma with pure red cell aplasia and amegakaryocytic thrombocytopenia. Hematol Rep 2016;8:6680.
    Pubmed
  5. Kondo K, Yoshizawa K, Tsuyuguchi M, et al. WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg 2004;77:1183-1188.
    Pubmed
  6. Shelly S, Agmon-Levin N, Altman A, Shoenfeld Y. Thymoma and autoimmunity. Cell Mol Immunol 2011;8:199-202.
    Pubmed
  7. Thompson CA, Steensma DP. Pure red cell aplasia associated with thymoma: clinical insights from a 50-year single-institution experience. Br J Haematol 2006;135:405-407.
    Pubmed
  8. Maslovsky I, Gefel D, Uriev L, Ben Dor D, Lugassy G. Malignant thymoma complicated by amegakaryocytic thrombocytopenic purpura. Eur J Intern Med 2005;16:523-524.
    Pubmed
  9. Kobayashi H, Kitano K, Ishida F, et al. Aplastic anemia and idiopathic thrombocytopenic purpura with antibody to platelet glycoprotein IIb/IIIa following resection of malignant thymoma. Acta Haematol 1993;90:42-45.
    Pubmed
  10. Bussel JB, Cheng G, Saleh MN, et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. N Engl J Med 2007;357:2237-2247.
    Pubmed
  11. Cheng G, Saleh MN, Marcher C, et al. Eltrombopag for management of chronic immune thrombocytopenia (RAISE): a 6-month, randomised, phase 3 study. Lancet 2011;377:393-402.
    Pubmed

Article

Letter to the Editor

Blood Res 2019; 54(1): 74-79

Published online March 31, 2019 https://doi.org/10.5045/br.2019.54.1.74

Copyright © The Korean Society of Hematology.

A case of immune thrombocytopenia associated with invasive thymoma successfully treated with eltrombopag

Jung-Ki Yoon1,2,#, Hee Ryeong Jang3,#, Jin Hyun Park1, Ki Hwan Kim1, Eu Youn Roh4, and Ja Min Byun1,2*

1Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.

2Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

3Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea.

4Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.

Correspondence to: Ja Min Byun. Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramaero-5-gil, Dongjak-gu, Seoul 07061, Korea. jaminbyun@naver.com

Received: July 9, 2018; Revised: August 30, 2018; Accepted: October 12, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Fig 1.

    Figure 1.

    Chest computed tomography (A) at diagnosis, (B) after three cycles of CAP, and (C) six months after completion of chemotherapy.

    Blood Research 2019; 54: 74-79https://doi.org/10.5045/br.2019.54.1.74

    Fig 2.

    Figure 2.

    (A) Picture of bone marrow at diagnosis. The section shows normocellular marrow without malignant tumor cells (H&E stain, ×400). (B) Second bone marrow examination was performed before the third cycle of chemotherapy. The section (H&E stain, ×400) showed nearly normal distribution of nucleated cells without infiltrative tumor cells. (C) Final bone marrow examination was performed before administration of eltrombopag. The section (H&E stain, ×400) shows normocellular marrow with slightly increased megakaryocytes (right side).

    Blood Research 2019; 54: 74-79https://doi.org/10.5045/br.2019.54.1.74

    Fig 3.

    Figure 3.

    Treatment course and serial platelet counts.

    Blood Research 2019; 54: 74-79https://doi.org/10.5045/br.2019.54.1.74

    References

    1. Hoffacker V, Schultz A, Tiesinga JJ, et al. Thymomas alter the T-cell subset composition in the blood: a potential mechanism for thymoma-associated autoimmune disease. Blood 2000;96:3872-3879.
      Pubmed
    2. Rivoisy C, Besse B, Girard N, et al. Thymic epithelial tumor-associated cytopenia: a 10-year observational study in France. J Thorac Oncol 2016;11:391-399.
      Pubmed
    3. Qin J, Liu L. Thymoma with idiopathic thrombocytopenic purpura: report of a case. J Thorac Cardiovasc Surg 2005;129:453.
      Pubmed
    4. Onuki T, Kiyoki Y, Ueda S, Yamaoka M, Shimizu S, Inagaki M. Invasive thymoma with pure red cell aplasia and amegakaryocytic thrombocytopenia. Hematol Rep 2016;8:6680.
      Pubmed
    5. Kondo K, Yoshizawa K, Tsuyuguchi M, et al. WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg 2004;77:1183-1188.
      Pubmed
    6. Shelly S, Agmon-Levin N, Altman A, Shoenfeld Y. Thymoma and autoimmunity. Cell Mol Immunol 2011;8:199-202.
      Pubmed
    7. Thompson CA, Steensma DP. Pure red cell aplasia associated with thymoma: clinical insights from a 50-year single-institution experience. Br J Haematol 2006;135:405-407.
      Pubmed
    8. Maslovsky I, Gefel D, Uriev L, Ben Dor D, Lugassy G. Malignant thymoma complicated by amegakaryocytic thrombocytopenic purpura. Eur J Intern Med 2005;16:523-524.
      Pubmed
    9. Kobayashi H, Kitano K, Ishida F, et al. Aplastic anemia and idiopathic thrombocytopenic purpura with antibody to platelet glycoprotein IIb/IIIa following resection of malignant thymoma. Acta Haematol 1993;90:42-45.
      Pubmed
    10. Bussel JB, Cheng G, Saleh MN, et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. N Engl J Med 2007;357:2237-2247.
      Pubmed
    11. Cheng G, Saleh MN, Marcher C, et al. Eltrombopag for management of chronic immune thrombocytopenia (RAISE): a 6-month, randomised, phase 3 study. Lancet 2011;377:393-402.
      Pubmed
    Blood Res
    Volume 59 2024

    Stats or Metrics

    Share this article on

    • line

    Blood Research

    pISSN 2287-979X
    eISSN 2288-0011
    qr-code Download