Romiplostim use for thrombocytopenia following allogeneic hematopoietic stem cell transplantation: a case series from a single center in Qatar

Thrombocytopenia is a common and serious complication that can occur following hematopoietic stem cell transplantation (HSCT), and it contributes to increased morbidity and mortality. The mechanisms of post-HSCT thrombocytopenia are multifactorial and complex. There are no clear consensus and guidelines for managing thrombocytopenia post-HSCT. Recently, there has been promising use of thrombopoietin receptor agonists (TPO-RAs), particularly eltrombopag and romiplostim, as treatments for post-HSCT thrombocytopenia. Notably, that this indication is considered off-label, and data in this use are limited. Based on the existing body of evidence, romiplostim emerges as a safe and effective option for individuals with transfusion-dependent thrombocytopenia after HSCT. In this context, we present a summary of our experience at a single center, where romiplostim was used in the management of post-HSCT thrombocytopenia due to poor graft function. Notably, all four cases responded positively to romiplostim treatment, and no significant adverse events were observed.