Management of chemotherapy-induced thrombocytopenia: guidance from the ISTH Subcommittee on Hemostasis and Malignancy

Gerald Soff, Avi Leader, Hanny Al-Samkari, Anna Falanga, Anthony Maraveyas, Kristen Sanfilippo, Tzu Fei Wang, Jeffrey Zwicker

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Thrombocytopenia is a common adverse effect of chemotherapy. The development of chemotherapy-induced thrombocytopenia (CIT) is influenced by cancer type and therapy, occurring in approximately one-third of patients with a solid tumor diagnosis and half of all patients with a hematologic malignancy. CIT may complicate the administration of chemotherapy, leading to therapeutic delays or dose reductions. This guidance document, presented by the International Society on Thrombosis and Haemostasis (ISTH) Subcommittee on Hemostasis and Malignancy, provides a comprehensive summary of the evidence and offers direction on the use of thrombopoietin receptor agonists (TPO-RAs) in various settings of CIT, including solid tumors, acute myeloid leukemia, stem cell transplant, and lymphoma. Studies have shown that TPO-RAs can improve platelet counts in CIT, but the clinical benefits of TPO-RA in terms of reducing bleeding, limiting platelet transfusion, avoiding chemotherapy delay, or dose reduction are uncertain. Further research is needed to optimize the selection of appropriate indications and study design to manage thrombocytopenia following chemotherapy.

Original languageEnglish
Pages (from-to)53-60
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Volume22
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • chemotherapy
  • hemorrhage
  • romiplostim
  • thrombocytopenia
  • thrombopoietin receptor agonists

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