Professor Li Junmin The advantages are fully displayed, and the future can be expected, and the unique mechanism of ropsitine helps to build a new pattern of ITP diagnosis and treatment

From July 9 to 13, 2022, the 30th International Society for Thrombotic and Hemostatic Society (ISTH) announced a number of research advances
in the field of hematology.

Considerable progress has been made in the field of hematology, and acute myeloid leukemia (AML) remains one
of the worst prognostic types of hematologic tumors.

With the development of the times and the continuous emergence of new treatment methods, AML prognosis continues to improve, and the cure can be expected in the future, but it is still facing
complications such as thrombocytopenia during treatment.

As a drug for thrombocytopenia, the world's first innovative long-acting thrombopoietin-receptor agonist (TPO-RA), ropsitine was approved in China this year for the treatment of primary immune thrombocytopenia (ITP
).

On this occasion, Professor Li Junmin of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine was specially invited to interpret
the current diagnosis and treatment progress of ML and the current status of ITP diagnosis and treatment.

The 2022 ISTH Conference was recently held, at which a number of research advances
in the field of hematology were announced.

You have been deeply involved in the field of hematology for many years and witnessed the development of AML therapy in China, can you tell us about the transformation that AML treatment is undergoing?

Professor
Li Junmin Leukemia is a representative disease of hematological tumors, the best model for tumor research, and has led the development of
hematological tumor treatment.

Based on your many years of clinical experience, what adverse reactions or complications do you think need to be paid attention to when treating AML?

Professor Li Junmin

Chemotherapy has a killing effect on normal cells and tumor cells, many general-targeted drugs in targeted therapy also have an impact on normal cells, and the pretreatment before hematopoietic stem cell transplantation causes bone marrow emptying, in short, chemotherapy, targeted therapy or hematopoietic stem cell transplantation and other treatment methods will affect normal hematopoietic function
.

A significant decrease in the number of hematopoietic cells will lead to a certain degree of bone marrow suppression, mainly manifested by a decrease
in the number of granules, red blood cells and platelets in the blood.

Granulocytopenia increases the risk of
infection.

Erythrocytopenia can lead to insufficient oxygen supply in the body, and patients will experience symptoms
such as fatigue and dizziness.

Thrombocytopenia increases the risk of bleeding, and fatal bleeding
may occur in individual patients.

In addition, granulocytes, red blood cells, and thrombocytopenia can also lead to decreased immunity and organ function changes and damage
.

However, after effective treatment, most adverse reactions can be controlled
.

Yimaitong: You just mentioned the complications of AML treatment such as chemotherapy and hematopoietic stem cell transplantation - thrombocytopenia, can you please tell us how this complication is currently handled clinically?

Professor Li Junmin

Thrombocytopenia due to radiotherapy, chemotherapy, targeting, or transplantation is common
in the clinic.

The biggest threat to patients with thrombocytopenia is bleeding caused by low platelets, so platelet transfusion therapy is needed in an emergency situation to help patients stop bleeding and raise platelet counts to a safe level
.

The main cause of drug-induced thrombocytopenia is insufficient
platelet production.

As a drug for the treatment of thrombocytopenia, the world's first innovative long-acting TPO-RA ropsitine was approved in China in 2022 for the treatment of ITP
.

Could you please briefly describe the advantages of ropsteen and ropsitine over other TPO-RAs in the treatment of ITP?

Professor Li Junmin

ITP is an acquired autoimmune hemorrhagic disorder that occurs in one of the causes of immune-mediated damage to megakaryocytes or inhibition of platelet release by megakaryocytes, which triggers decreased
platelet production.

The platelet-stimulating drug ropsitine was launched in China this year, providing a new treatment option
for patients with ITP.

I am also involved in the early clinical trial
of this drug in the Department of Hematology of Shanghai Ruijin Hospital.

The efficacy of ropsitine is very good, the early response rate is high, close to 80% after 1 week, up to 90% after 2 weeks, and the overall platelet response rate is as high as 80%-95%, which has the advantage of
rapid plate rise and high effect response in ITP therapy.

Ropstigine also has the characteristics of long-lasting efficacy, and its probability of no therapeutic remission is about 2 times that of small molecule non-peptide TPO-RA
.

Compared with other small molecules of non-peptide TPO-RA, ropsitine can phosphorylate TPO receptors, activate more downstream signaling pathways, including JAK2-STAT5, STAT3, PI3K/AKT, etc.
, in which the signal intensity is higher when activating the JAK2-STAT5 pathway, twice as fast, and the unique STAT3 pathway can not only promote the maturation and proliferation of megakaryocytes, but also may also regulate immunity
.

The long-lasting effect of ropsitine is due to this mechanism of
action.

Medical Pulse Pass: Ropsitine has the advantages of fast onset, high response rate, long-lasting effect, etc.
, which makes up for the lack of existing therapeutic drugs, can you talk about the significance of its inclusion in medical insurance?

Professor Li Junmin ITP
is a relatively common chronic disease with a large
number of patients.

First-line treatment of ITP is glucocorticoids, but some patients are prone to relapse
after first-line therapy.

TPO-RA has been recommended by ITP guidelines or expert consensus at home and abroad, and has become an important choice for
second-line ITP treatment.

The government's inclusion of the price of ITP drugs in the scope of government supervision and the adjustment of medical insurance policies can effectively reduce the burden of medical expenses on
patients.

In recent years, TPO-RA has entered health insurance, improving the accessibility of
drugs.

As a new drug of the same kind, ropsitine has excellent efficacy and should have the opportunity to be included in medical insurance to benefit more ITP patients
.

Professor Li Junmin

• Director of the Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

• Vice President of Hematology Branch of Chinese Medical Doctor Association

• President of Hematology Branch of Chinese Geriatrics Association

• Chairman of Shanghai Hematology Branch of Chinese Medical Association

• Chairman of Shanghai Hematology and Oncology Professional Committee of Chinese Anti-Cancer Association

• Vice President of Blood Branch of China Association for the Promotion of Medicine

Editor: May Review: Janet Typography : Moly Execution: Moly

Poke "Read the original article" to see more