case_images: PMC11813053_01
case_images: The patient's medical history of treatment for ITP. ITP = immune thrombocytopenia.
case_images: medi-104-e41449-g001.jpg
case_images: PMC11813053_01_medi-104-e41449-g001.jpg
case_images: F1
case_images: He was later referred to our hospital for further treatment (Fig. 1).
case_images: The first day of treatment is designated as day 1. The patient received low-dose DAC for 3 days and rhTPO for 14 days, resulting in a platelet count increaseto 221 x 109/L by day 29. After 4 weeks, the patient was treated with the same-dose DAC without rhTPO, leading to a decline in platelet levels. DAC = low-dose decitabine, rh = recombinant human, TPO = thrombopoietin.
case_images: medi-104-e41449-g002.jpg
case_images: PMC11813053_01_medi-104-e41449-g002.jpg
case_images: F2
case_images: DAC, such as renal function deterioration, were observed. Due to financial constraints, the patient discontinued further diagnosis and treatment, leading to a gradual decrease in his platelet count to 5 x 109/L (Fig. 2).
case_images: PMC11813053_02
case_images: The patient exhibited a poor platelet response during the initial treatment with eltrombopag, as noted during the first week of treatment. Low-dose DAC was initiated at week 9, leading to a rise in platelet count by week 12, followed by a decline at week 14, with persistently low platelet response thereafter. At week 17, combination therapy with eltrombopag and DAC was administered for 8 weeks, during which platelet counts began to rise at week 20 and reached normal levels (>100 x 109/L) by week 24. At 3 months of follow-up, platelet counts remained within the normal range, although minor fluctuations were observed. DAC = low-dose decitabine.
case_images: medi-104-e41449-g003.jpg
case_images: PMC11813053_02_medi-104-e41449-g003.jpg
case_images: F3
case_images: Her platelet count remained stable within the normal range until May 2023 (Fig. 3).