e24161 Background: Chemotherapy-induced thrombocytopenia (CIT) is a frequent complication, resulting in increased bleeding risk, chemotherapy dose reductions, delays or discontinuation. Thrombopoietin receptor agonists (TPO-RA), such as romiplostim (romi), represent a promising therapy for CIT by stimulating platelet production. Methods: Despite National Comprehensive Cancer Network guidance supporting romi or other TPO-RA use in CIT, real-world adoption remains inconsistent across all malignancies. We conducted a retrospective, single-center analysis of romi use for CIT from January 2020 to December 2024. Patients were included if they received romi within 6 months following chemotherapy. This study evaluated achievement of platelet count (×10 9 /L) ≥100 and > 50, time to platelet recovery, dosing patterns, thromboembolic and bleeding events, and chemotherapy dose delay/reductions. Results: Of 121 patients included (median age 58; 69% female), 56% had solid tumors and 44% had hematologic malignancies. The most common chemotherapy regimens prior to the development of thrombocytopenia included carboplatin-based regimens, azacitidine/venetoclax, and FOLFOX-based regimens. Prior to romi initiation, median platelet count was 26. About 12% of patients had a platelet count ≥ 100 prior to romi initiation. After romi initiation, 74% of patients achieved platelets ≥ 100 with a median time of 16 days (patients with a platelet count > 100 were not included in this data point). The median romi dose was 5 mcg/kg during treatment. Dose delays or reductions were avoided in 70% of patients. During romi therapy, bleeding and thrombotic events occurred in 10% and 0.8% respectively. Conclusions: In our study, romi was effective at achieving a platelet goal of > 100 in the majority of our patients. Limitations include a single center study, heterogenous patient population and a lack of comparison to patients who did not receive romi despite similar degrees of thrombocytopenia. Further studies are needed to determine if romi affects overall survival, and to develop an effective dosing strategy for ROMI in CIT as a cost analysis. Outcomes Solid Hematologic Achieved platelets > 100 x 10 9 (n, %) 43, 63.2% 33, 62.3% Achieved platelets > 50 x 10 9 (n, %) 26, 38.2% 36, 68% Not requiring chemotherapy delay or dose reduction (n, %) 48, 70.6% 37, 69.8% Median romi dose during treatment (mcg/kg) 3.5 6.4 Side Effect/Safety Profile Bleeding events recorded during romi (n, %) 6, 8.8% 6, 11.3% Thrombotic events recorded during romi (n, %) 1, 1.5% 0, 0%
Shah et al. (Thu,) studied this question.