{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T20:27:09Z","timestamp":1778531229223,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,4]],"date-time":"2016-04-04T00:00:00Z","timestamp":1459728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>In patients with immune thrombocytopenia (ITP) refractory to corticosteroids and intravenous immunoglobulins (IVIG), splenectomy may result at higher risk of peri\u2010operative complications and, for this reason, potentially contraindicated. The thrombopoietin receptor agonists (TPO\u2010RAs) romiplostim and eltrombopag have shown high therapeutic activity in primary ITP, but data of efficacy and safety regarding their use in preparation for splenectomy are missing. Thirty\u2010one adult patients, median age 50 years, with corticosteroids and\/or IVIG refractory persistent and chronic ITP who were treated with TPO\u2010RAs (romiplostim= 24; eltrombopag= 7) with the aim to increase platelet count and allow a safer execution of splenectomy were retrospectively evaluated. Twenty\u2010four patients (77%) responded to the use of TPO\u2010RAs with a median platelet count that increased from 11 \u00d7 10<jats:sup>9<\/jats:sup>\/L before starting TPO\u2010RAs to 114 \u00d7 10<jats:sup>9<\/jats:sup>\/L pre\u2010splenectomy, but a concomitant treatment with corticosteroids and\/or IVIG was required in 19 patients. Twenty\u2010nine patients underwent splenectomy while two patients who responded to TPO\u2010RAs subsequently refused surgery. Post\u2010splenectomy complications were characterized by two Grade 3 thrombotic events (1 portal vein thrombosis in the patient with previous history of HCV hepatitis and 1 pulmonary embolism), with a platelet count at the time of thrombosis of 260 and 167 \u00d7 10<jats:sup>9<\/jats:sup>\/L, respectively and one Grade 3 infectious event. TPO\u2010RAs may represent a therapeutic option to improve platelet count and reduce the risk of peri\u2010operative complications in ITP candidates to splenectomy. An increased risk of post\u2010splenectomy thromboembolic events cannot be ruled out and thromboprophylaxis with low\u2010molecular weight heparin is generally recommended. Am. J. Hematol. 91:E293\u2013E295, 2016. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24341","type":"journal-article","created":{"date-parts":[[2016,2,25]],"date-time":"2016-02-25T04:32:20Z","timestamp":1456374740000},"source":"Crossref","is-referenced-by-count":32,"title":["Thrombopoietin receptor agonists for preparing adult patients with immune thrombocytopenia to splenectomy: results of a retrospective, observational <scp>GIMEMA<\/scp> study"],"prefix":"10.1002","volume":"91","author":[{"given":"Francesco","family":"Zaja","sequence":"first","affiliation":[{"name":"Clinica Ematologica, DISM, a O U S. M. 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