What question did this study set out to answer?

To evaluate the efficacy of avatrombopag in improving platelet recovery and reducing transfusion needs in haematological patients with thrombocytopenia.

March 10, 2026Open Access

Avatrombopag Reduces Platelet Transfusion Requirement in Thrombocytopenia Subsequent to Antineoplastic Therapies in Haematological Patients: The Experience of a Tertiary Centre

Key Points

To evaluate the efficacy of avatrombopag in improving platelet recovery and reducing transfusion needs in haematological patients with thrombocytopenia.
Retrospective observational study
Included haematological patients with persistent thrombocytopenia (≥3 weeks)
Patients treated with avatrombopag between November 2023 and December 2024
23 patients were recruited, with 82.6% responding to avatrombopag
43.5% achieved partial response (platelet counts ≥30 × 10^9/L)
39.1% achieved complete response (platelet counts ≥100 × 10^9/L)
Transfusion requirements decreased significantly, from a median of 11 to 0 prior to treatment (p = 0.007)
56.5% of patients no longer required any transfusions at treatment end

Abstract

Background/Objectives: Thrombocytopenia subsequent to antineoplastic therapies leads to bleeding complications, treatment delay or de-intensification, and platelet transfusion requirement. Evidence suggests that thrombopoietin receptor agonists (TPO-RAs) can restore platelet counts in this scenario. Avatrombopag (AVA) is an oral TPO-RA whose efficacy in treating thrombocytopenia in haematological malignancy has been barely addressed. We aimed to evaluate AVA’s efficacy in improving platelet recovery and reducing transfusion requirement in haematological patients with thrombocytopenia. Methods: In this retrospective observational study, haematological patients who developed thrombocytopenia persisting for ≥3 weeks and were treated with AVA between November 2023 and December 2024 were recruited. Results: Twenty-three patients were recruited. Nineteen (82.6%) responded to AVA, most within the first 4 weeks: 10 (43.5%) and 9 (39.1%) achieved platelet counts ≥ 30 × 109/L (partial response) and ≥100 × 109/L (complete response), respectively. Response was always maintained for 30 days after AVA withdrawal. Transfusions were significantly fewer than in the previous period: 0 (0–8) vs. 11 (2–15), median (interquartile range IQR), p = 0.007. Once on treatment, 13 (56.5%) patients no longer required transfusion. No patient delayed or de-intensified chemotherapy. No safety concerns were reported. Conclusions: AVA shows promise in safely reducing thrombocytopenia-associated transfusion needs in haematological malignancy.

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