Role of romiplostim in splenectomized and nonsplenectomized patients with immune thrombocytopenia

Abstract

Jose Perdomo Hematology Research Unit, St George and Sutherland Clinical School, University of New South Wales, Kogarah, NSW, Australia Abstract: Romiplostim is a thrombopoietin receptor agonist (TPO-RA) used for the treatment of adult primary immune thrombocytopenia (ITP). ITP is an autoimmune condition characterized by low platelet counts due to increased destruction and reduced platelet production. First-line interventions include corticosteroids, anti-D, and intravenous immunoglobulins, while second-line therapies comprise splenectomy, rituximab, cyclosporine A, and TPO-RAs. The recognition that compromised platelet production is a critical part of the pathogenesis of ITP prompted the development of therapeutic strategies based on the stimulation of the TPO receptor. TPO-RAs enhance megakaryocyte proliferation, increase platelet production, and lead to a reduction in bleeding episodes in ITP patients. This review will summarize current data on the TPO-RA romiplostim, with a particular focus on its relation to splenectomy. Keywords: idiopathic thrombocytopenic purpura, thrombopoietin mimetic peptide, romiplostim, splenectomy, blood platelets

Keywords

• Idiopathic thrombocytopenic purpura
• thrombopoietin mimetic peptide
• romiplostim
• splenectomy
• blood platelets