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Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy.

Publication ,  Journal Article
Ha, CI; DeArmey, S; Cope, H; Rairikar, M; Kishnani, PS
Published in: Mol Genet Metab Rep
September 2017

The availability of three enzyme replacement therapy (ERT) drugs and two substrate reduction therapy (SRT) drugs to treat Gaucher disease provides an opportunity to tailor therapies to a patient's specific clinical concerns. However, there is a gap in the literature regarding individual drug effectiveness in treating particular symptoms and the potential benefits of combination treatment. This report details treatment of a patient with Gaucher disease type 1 whose main clinical concern was profound thrombocytopenia (around 20 × 109/L, normal range: 150-450 × 109/L) with several episodes of bleeding with minimal trauma and bruises. The patient was treated with ERT at doses up to 60 units/kg weekly, with no improvement in platelet levels for 6 years. Subsequently, the patient transitioned to SRT and platelet levels increased almost two fold within the first month, and have remained stable at safe levels (30-60 × 109/L) for almost 2.5 years at the time of publication. This report demonstrates a possible therapeutic benefit of SRT in individual patients who do not meet therapeutic goals in terms of thrombocytopenia after a considerable period on first-line ERT treatment. Oral administration of SRT also improved this patient's quality of life allowing discontinuation of weekly ERT infusions, which better accommodated her demanding career and busy lifestyle.

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Published In

Mol Genet Metab Rep

DOI

ISSN

2214-4269

Publication Date

September 2017

Volume

12

Start / End Page

82 / 84

Location

United States

Related Subject Headings

  • 3202 Clinical sciences
  • 3105 Genetics
  • 0604 Genetics
  • 0601 Biochemistry and Cell Biology
 

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Ha, C. I., DeArmey, S., Cope, H., Rairikar, M., & Kishnani, P. S. (2017). Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy. Mol Genet Metab Rep, 12, 82–84. https://doi.org/10.1016/j.ymgmr.2017.06.003
Ha, Christine I., Stephanie DeArmey, Heidi Cope, Mugdha Rairikar, and Priya S. Kishnani. “Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy.Mol Genet Metab Rep 12 (September 2017): 82–84. https://doi.org/10.1016/j.ymgmr.2017.06.003.
Ha CI, DeArmey S, Cope H, Rairikar M, Kishnani PS. Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy. Mol Genet Metab Rep. 2017 Sep;12:82–4.
Ha, Christine I., et al. “Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy.Mol Genet Metab Rep, vol. 12, Sept. 2017, pp. 82–84. Pubmed, doi:10.1016/j.ymgmr.2017.06.003.
Ha CI, DeArmey S, Cope H, Rairikar M, Kishnani PS. Treatment of profound thrombocytopenia in a patient with Gaucher disease type 1: Is there a role for substrate reduction therapy. Mol Genet Metab Rep. 2017 Sep;12:82–84.
Journal cover image

Published In

Mol Genet Metab Rep

DOI

ISSN

2214-4269

Publication Date

September 2017

Volume

12

Start / End Page

82 / 84

Location

United States

Related Subject Headings

  • 3202 Clinical sciences
  • 3105 Genetics
  • 0604 Genetics
  • 0601 Biochemistry and Cell Biology