{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:28:14Z","timestamp":1787761694585,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"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;amp; Cancer"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thrombopoietin receptor agonists (TPO\u2010RAs) have demonstrated efficacy in treating clinically significant thrombocytopenia, including chemotherapy\u2010induced thrombocytopenia in adults. However, data regarding their safety and efficacy in pediatric, adolescents, and young adult (AYA) patients with hematologic malignancies are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively identified 15 pediatric and AYA patients aged 25 years or younger with hematologic malignancies treated with a TPO\u2010RA at UCSF Benioff Children's Hospitals between 2015 and 2023. Platelet counts and transfusion requirements were compared before and after TPO\u2010RA therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age at TPO\u2010RA initiation was 16 years (range: 7\u201325 years). Nine patients (60%) had a history of bleeding or comorbidity that predisposed to severe bleeding risk. Eleven patients received romiplostim and four patients received eltrombopag. The median platelet count significantly increased from 24\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L at baseline to 54\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L after 3 weeks of any TPO\u2010RA therapy (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.029). Monthly platelet transfusion requirements significantly decreased from a median of 15 to two units after TPO\u2010RA therapy (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007). Fourteen of the 15 patients (93%) achieved a sustained platelet count &gt;50,000\/\u00b5L within 8 weeks, with a median time to response of 3 weeks. No TPO\u2010RA\u2010related adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TPO\u2010RAs were effective in managing refractory thrombocytopenia in pediatric and young adult patients being treated for hematologic malignancies, with a favorable safety profile, even among patients with multiple comorbidities. These findings warrant further investigation through prospective clinical trials to confirm efficacy and establish clinical guidelines for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.31528","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T01:04:00Z","timestamp":1736384640000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Thrombopoietin Receptor Agonists for Thrombocytopenia in Pediatric Hematologic Malignancies"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8600-6400","authenticated-orcid":false,"given":"Amanda E.","family":"Marinoff","sequence":"first","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Thrall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Aaronson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin S.","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Castellanos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Hermiston","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"},{"name":"VinUniversity (Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc VinUni) Vinhomes Ocean Park  Gia L\u00e2m Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Levinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Southworth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6909-8072","authenticated-orcid":false,"given":"Beth Apsel","family":"Winger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Olshen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-4623","authenticated-orcid":false,"given":"Elliot","family":"Stieglitz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Benioff Children's Hospitals, University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation.V2012.1.499.3798531"},{"issue":"8","key":"e_1_2_9_3_1","first-page":"21","article-title":"Dose Reductions and Delays: Limitations of Myelosuppressive Chemotherapy","volume":"14","author":"Cairo M. S.","year":"2000","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2022000374"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29776"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00279-8"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61107-2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613878"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.09.010"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa073255"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60203-2"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002625"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.251900"},{"issue":"4","key":"e_1_2_9_14_1","first-page":"282","article-title":"Managing Thrombocytopenia Associated With Cancer Chemotherapy","volume":"29","author":"Kuter D. J.","year":"2015","journal-title":"Oncology"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01931"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-2074-2"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13175117"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-022-04889-6"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26473"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29548"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001187"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.0026"},{"key":"e_1_2_9_23_1","unstructured":"National Cancer Institute.Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0(2017)."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2019-0684"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23796"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(17)30228-4"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28663"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-06-2552"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-219493"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.7999"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-85321-3"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019004043"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31528","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.31528","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:03:08Z","timestamp":1787760188000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/pbc.31528"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31528","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.173028310.04745743\/v1","asserted-by":"object"}]},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]},"assertion":[{"value":"2024-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31528"}}