Efficacy of immunomodulatory therapy with all-trans retinoid acid in adult patients with chronic immune thrombocytopenia

- We evaluated the efficacy of immunomodulatory therapy with all-trans retinoid acid (ATRA) in chronic ITP (CITP).
- 35 CITP received ATRA treatment, of whom 10 and 19 patients achieved complete response and overall response, respectively.
- We found ATRA therapy could significantly increase the percentage of Treg cells, IL-10 level and Foxp3 expression in CITP.

IntroductionImmune thrombocytopenia (ITP) is a common hematologic disorder characterized by isolated thrombocytopenia. In adults, ITP is more likely to be chronic, requiring individualised treatment and management. Corticosteroids and splenectomy are the most common therapy for ITP. However, these routine approaches failed in these patients with chronic ITP. The aim of this study was to evaluate the efficacy of immunomodulatory therapy with all-trans retinoid acid (ATRA) in adult patients with chronic ITP.Materials and methodsATRA therapy was applied in a total of 35 patients with chronic ITP who failed with standard dose corticosteroids and/or splenectomy. The response ratio and the change of the T cell subsets including Th1, Th2, Th17 and Treg, were evaluated.ResultsComplete response and overall response were observed in 10 (28.6%) and 19 patients (54.3%), respectively. Compared with the control group, a significant decreased level of Treg cells, IL-10 and Foxp3 expression were found in ITP patients. ATRA therapy could significantly increase the percentage of Treg cell, IL-10 level and Foxp3 expression.ConclusionsOur findings indicate that ATRA therapy could induce significant changes of Treg cells to induce response in patients with chronic ITP.