{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:35:34Z","timestamp":1787758534056,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delayed platelet recovery remains a frequent and clinically significant complication following hematopoietic stem cell transplantation (HSCT) in children, contributing to increased transfusion burden, bleeding risk, and prolonged hospitalization. Thrombopoietin receptor agonists (TPO\u2010RAs), including romiplostim, have demonstrated activity in post\u2010transplant thrombocytopenia; however, prospective pediatric data on their early post\u2010transplant use are limited. We evaluated the safety and potential effects of early romiplostim administration on platelet and hematopoietic recovery following pediatric HSCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, open\u2010label, randomized pilot study conducted at a tertiary care center in India, children aged 1\u201318\u00a0years undergoing autologous or allogeneic HSCT were randomized (1:1) to receive standard post\u2010transplant care with or without romiplostim. Romiplostim (5\u00a0\u00b5g\/kg subcutaneously) was administered on Days +1 and +8 post\u2010transplant (or Days +5 and +12 for haploidentical transplants with post\u2010transplant cyclophosphamide). The primary endpoint was time to platelet engraftment (platelet count \u226520 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L for 3 consecutive days without transfusion). Secondary endpoints included platelet transfusion requirements, platelet nadir, platelet counts on Day +28, time to platelet count \u226550 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L, neutrophil recovery, bleeding, and thrombotic events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010two children were enrolled (romiplostim\n                      <jats:italic>n<\/jats:italic>\n                      = 17; control\n                      <jats:italic>n<\/jats:italic>\n                      = 15). Median time to platelet engraftment was comparable between the romiplostim and control groups (12 vs. 12.5\u00a0days;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.88), with no significant difference on Kaplan\u2013Meier analysis. Platelet transfusion requirements, platelet nadir, and time to platelet count \u226550 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L were also similar between groups. By Day +28, higher platelet counts were observed in the romiplostim arm, with exploratory subgroup analysis demonstrating higher platelet counts following allogeneic HSCT. Romiplostim recipients also demonstrated higher absolute neutrophil counts on Day +28. No thrombotic events, severe bleeding episodes, or drug\u2010related serious adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early administration of romiplostim following pediatric HSCT was safe and well tolerated, with no significant treatment\u2010related toxicity observed. Although it did not shorten time to platelet engraftment, exploratory analyses demonstrated higher Day +28 platelet and neutrophil counts, generating the hypothesis that romiplostim may support sustained hematopoietic recovery. These findings require confirmation in larger, adequately powered multicenter studies before conclusions regarding efficacy can be drawn.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70586","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:16:16Z","timestamp":1784790976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hematopoietic Recovery and Safety Following Early Romiplostim Administration After Pediatric HSCT: A Prospective Randomized Pilot Study"],"prefix":"10.1002","volume":"73","author":[{"given":"Sanjana","family":"Sarangarajan","sequence":"first","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3730-8944","authenticated-orcid":false,"given":"Aditya Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagdish Prasad","family":"Meena","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neerja","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Jauhari","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi 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Transfusion Medicine All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-4914","authenticated-orcid":false,"given":"Sujata","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Stem Cell Facility All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Bakhshi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr BRA, IRCH All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheffali","family":"Gulati","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7746-547X","authenticated-orcid":false,"given":"Rachna","family":"Seth","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics All India Institute of Medical Sciences  New Delhi 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