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The thrombopoietin receptor agonists romiplostim and eltrombopag, which stimulate platelet production, have greatly improved the treatment of patients with immune thrombocytopenias JW Oncol Hematol Feb 12 2008. Despite the effectiveness of these agents, concerns have been raised about their potential to induce bone marrow fibrosis and hematologic malignancies. One industry-supported report addressed preclinical and clinical findings of fibrosis with romiplostim; a separate report discussed the malignant potential of eltrombopag in patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS).
ROMIPLOSTIM
Rats injected with romiplostim at doses up to 100 μg/kg (10 times the usual human dose) for 4 weeks exhibited significantly g…