{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T20:40:14Z","timestamp":1739220014719,"version":"3.37.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hangzhou Municipal Health Commission","award":["A20210210"],"award-info":[{"award-number":["A20210210"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2,7]]},"abstract":"<jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>Immune thrombocytopenia (ITP) is an autoimmune-mediated disorder caused by antibody-mediated platelet destruction and impaired platelet production by megakaryocytes. Treating refractory ITP remains a significant challenge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient Concerns and Diagnoses:<\/jats:title>\n            <jats:p>We report 2 patients with refractory ITP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions and Outcomes:<\/jats:title>\n            <jats:p>Two patients received low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag. Platelet counts in both patients increased to within the normal range.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>Low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag may exert a synergistic effect in the treatment of refractory ITP.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000041449","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T20:01:14Z","timestamp":1739217674000},"page":"e41449","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Refractory immune thrombocytopenia treated with low-dose decitabine combined with recombinant human thrombopoietin or eltrombopag: Two case reports"],"prefix":"10.1097","volume":"104","author":[{"given":"Yuxia","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7467-0256","authenticated-orcid":false,"given":"Yani","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Zhejiang Aged Care Hospital, Hangzhou, Zhejiang, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiying","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minxia","family":"He","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huifang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250210","doi-asserted-by":"crossref","first-page":"254","DOI":"10.5045\/br.2017.52.4.254","article-title":"Management of immune thrombocytopenia: Korean experts recommendation in 2017.","volume":"52","author":"Jang","year":"2017","journal-title":"Blood Res"},{"key":"R2-20250210","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s00277-022-04829-4","article-title":"Real-world experience of anti-D immunoglobulin in immune thrombocytopenia.","volume":"101","author":"Mishra","year":"2022","journal-title":"Ann Hematol"},{"key":"R3-20250210","first-page":"361","article-title":"Safety and efficacy of splenectomy in immune thrombocytopenia.","volume":"11","author":"Mishra","year":"2021","journal-title":"Am J Blood Res"},{"key":"R4-20250210","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1182\/blood.2019003599","article-title":"Identifying and treating refractory ITP: difficulty in diagnosis and role of combination treatment.","volume":"135","author":"Oriana","year":"2020","journal-title":"Blood"},{"key":"R5-20250210","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1182\/bloodadvances.2020002790","article-title":"Low-dose decitabine for refractory prolonged isolated thrombocytopenia after HCT: a randomized multicenter trial.","volume":"5","author":"Tang","year":"2021","journal-title":"Blood Adv"},{"key":"R6-20250210","first-page":"617","article-title":"Chinese guideline on the diagnosis and management of adult primary immune thrombocytopenia (version 2020).","volume":"41","year":"2020","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"R7-20250210","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1182\/blood-2016-03-603365","article-title":"How I treat refractory immune 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thrombocytopenia.","volume":"94","author":"Zhou","year":"2019","journal-title":"Am J Hematol"},{"key":"R11-20250210","doi-asserted-by":"crossref","first-page":"e487","DOI":"10.1016\/S2352-3026(17)30170-9","article-title":"Oral all-trans retinoic acid plus danazol versus danazol as second-line treatment in adults with primary immune thrombocytopenia: a multicentre, randomised, open-label, phase 2 trial.","volume":"4","author":"Feng","year":"2017","journal-title":"Lancet Haematol"},{"key":"R12-20250210","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1111\/jth.13767","article-title":"High-dose dexamethasone or all-trans-retinoic acid restores the balance of macrophages towards M2 in immune thrombocytopenia.","volume":"15","author":"Feng","year":"2017","journal-title":"J Thromb Haemost"},{"key":"R13-20250210","doi-asserted-by":"crossref","first-page":"100279","DOI":"10.1016\/j.rpth.2023.100279","article-title":"Eltrombopag plus cyclosporine in refractory immune thrombocytopenia: a single-center study.","volume":"7","author":"Hong","year":"2023","journal-title":"Res Pract Thromb Haemost"},{"key":"R14-20250210","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1182\/blood.2020008477","article-title":"Low-dose decitabine modulates T-cell homeostasis and restores immune tolerance in immune thrombocytopenia.","volume":"138","author":"Han","year":"2021","journal-title":"Blood"},{"key":"R15-20250210","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.3892\/ol.2016.4259","article-title":"Effects of decitabine on megakaryocyte maturation in patients with myelodysplastic syndromes.","volume":"11","author":"Ding","year":"2016","journal-title":"Oncol Lett"},{"key":"R16-20250210","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1160\/TH14-04-0342","article-title":"Low-dose decitabine promotes megakaryocyte maturation and platelet production in healthy controls and immune 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