{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:29:26Z","timestamp":1794047366913,"version":"4.8.0"},"reference-count":28,"publisher":"Ferrata Storti Foundation (Haematologica)","issue":"11","license":[{"start":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T00:00:00Z","timestamp":1600041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["haematol"],"abstract":"<jats:p>Approximately 20-50% patients with chronic phase chronic myeloid leukemia (CML-CP) treated with tyrosine kinase inhibitors (TKI) or with myelofibrosis (MF) treated with ruxolitinib develop grade \u22653 thrombocytopenia needing treatment interruptions and dose reductions. We conducted a non-randomized, phase II, single-arm study to determine the efficacy of eltrombopag for patients with CML or MF with persistent thrombocytopenia while on TKI or ruxolitinib. Eltrombopag was initiated at 50 mg\/day, with dose escalation up to 300 mg daily allowed every 2 weeks. Twenty-one patients were enrolled (CML=15, MF=6); with a median age of 60 years (range, 31-97 years). The median platelet count was 44x109\/L (range, 3-49x109\/L) in CML and 62x109\/L (range, 21-75x109\/L) in MF. After a median of 18 months (range, 5-77 months), 12 of 15 patients with CML achieved complete platelet response. The median peak platelet count among responders was 154x109\/L (range, 74-893x109\/L). Among CML patients five could re-escalate the TKI dose and nine improved their response. None of the six patients with MF had a sustained response. Therapy was generally well tolerated. One patient discontinued therapy due to toxicity (elevated transaminases). One patient with CML developed significant thrombocytosis (&gt;1,000x109\/L). Another CML patient developed non occlusive deep venous thrombosis in the right upper extremity without thrombocytosis, and one MF patient had myocardial infarction. Eltrombopag may help improve platelet counts in CML patients receiving TKI with recurrent thrombocytopenia. Further studies are warranted (clinicaltrials gov. Identifier: NCT01428635).<\/jats:p>","DOI":"10.3324\/haematol.2020.260125","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T14:41:22Z","timestamp":1600353682000},"page":"2853-2858","source":"Crossref","is-referenced-by-count":23,"title":["The effect of eltrombopag in managing thrombocytopenia associated with tyrosine kinase therapy in patients with chronic myeloid leukemia and myelofibrosis"],"prefix":"10.3324","volume":"106","author":[{"given":"Mahran","family":"Shoukier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Borthakur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Jabbour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Ravandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Garcia-Manero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapan","family":"Kadia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo","family":"Matthews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Masarova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Naqvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srdan","family":"Verstovsek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Cortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1856","published-online":{"date-parts":[[2020,9,14]]},"reference":[{"key":"30840","doi-asserted-by":"crossref","unstructured":"Kantarjian HM, Cortes JE, O'Brien S. Imatinib mesylate therapy in newly diagnosed patients with Philadelphia chromosome- positive chronic myelogenous leukemia: high incidence of early complete and major cytogenetic responses. Blood. 2003; 101(1):97-100.","DOI":"10.1182\/blood-2002-02-0545"},{"key":"30841","doi-asserted-by":"crossref","unstructured":"Kantarjian H, Shah NP, Hochhaus A. Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2010; 362(24):2260-2270.","DOI":"10.1056\/NEJMoa1002315"},{"key":"30842","doi-asserted-by":"crossref","unstructured":"Cortes JE, Jones D, O'Brien S. Nilotinib as front-line treatment for patients with chronic myeloid leukemia in early chronic phase. J Clin Oncol. 2010; 28(3):392-397.","DOI":"10.1200\/JCO.2009.25.4896"},{"key":"30843","doi-asserted-by":"crossref","unstructured":"Cortes JE, Kim DW, Kantarjian HM. Bosutinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia: results from the BELA trial. J Clin Oncol. 2012; 30(28):3486-3492.","DOI":"10.1200\/JCO.2011.38.7522"},{"key":"30844","doi-asserted-by":"crossref","unstructured":"Cortes JE, Kim DW, Pinilla-Ibarz J. A phase 2 trial of ponatinib in Philadelphia chromosome-positive leukemias. N Engl J Med. 2013; 369(19):1783-1796.","DOI":"10.1056\/NEJMoa1306494"},{"key":"30845","doi-asserted-by":"crossref","unstructured":"Hochhaus A, Kantarjian HM, Baccarani M. Dasatinib induces notable hematologic and cytogenetic responses in chronicphase chronic myeloid leukemia after failure of imatinib therapy. Blood. 2007; 109(6):2303-2309.","DOI":"10.1182\/blood-2006-09-047266"},{"key":"30846","unstructured":"Incyte Corporation. Jakafi (ruxolitinib) [package insert]. 2016. Publisher Full Text|"},{"key":"30847","doi-asserted-by":"crossref","unstructured":"Verstovsek S, Kantarjian H, Mesa RA. Safety and efficacy of INCB018424, a JAK1 and JAK2 inhibitor, in myelofibrosis. N Engl J Med. 2010; 363(12):1117-1127.","DOI":"10.1056\/NEJMoa1002028"},{"key":"30848","doi-asserted-by":"crossref","unstructured":"Harrison C, Kiladjian JJ, Al-Ali HK. JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med. 2012; 366(9):787-798.","DOI":"10.1056\/NEJMoa1110556"},{"key":"30849","doi-asserted-by":"crossref","unstructured":"Talpaz M, Paquette R, Afrin L. Interim analysis of safety and efficacy of ruxolitinib in patients with myelofibrosis and low platelet counts. J Hematol Oncol. 2013; 6(1):81.","DOI":"10.1186\/1756-8722-6-81"},{"key":"30850","doi-asserted-by":"crossref","unstructured":"Sneed TB, Kantarjian HM, Talpaz M. The significance of myelosuppression during therapy with imatinib mesylate in patients with chronic myelogenous leukemia in chronic phase. Cancer. 2004; 100(1):116-121.","DOI":"10.1002\/cncr.11863"},{"key":"30851","doi-asserted-by":"crossref","unstructured":"Verstovsek S, Gotlib J, Gupta V. Management of cytopenias in patients with myelofibrosis treated with ruxolitinib and effect of dose modifications on efficacy outcomes. Onco Targets Ther. 2013; 7:13-21.","DOI":"10.2147\/OTT.S53348"},{"key":"30852","doi-asserted-by":"crossref","unstructured":"Verstovsek S, Mesa RA, Gotlib J. A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. N Engl J Med. 2012; 366(9):799-807.","DOI":"10.1056\/NEJMoa1110557"},{"key":"30853","doi-asserted-by":"crossref","unstructured":"Quintas-Cardama A, Kantarjian H, O'Brien S. Granulocyte-colony-stimulating factor (filgrastim) may overcome imatinibinduced neutropenia in patients with chronic-phase chronic myelogenous leukemia. Cancer. 2004; 100(12):2592-2597.","DOI":"10.1002\/cncr.20285"},{"key":"30854","doi-asserted-by":"crossref","unstructured":"Cortes J, O'Brien S, Quintas A. Erythropoietin is effective in improving the anemia induced by imatinib mesylate therapy in patients with chronic myeloid leukemia in chronic phase. 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The role of interleukin-11 to prevent chemotherapy-induced thrombocytopenia in patients with solid tumors, lymphoma, acute myeloid leukemia and bone marrow failure syndromes. Leuk Lymphoma. 2007; 48(1):9-15.","DOI":"10.1080\/10428190600909115"},{"key":"30864","doi-asserted-by":"crossref","unstructured":"Cantor SB, Elting LS, Hudson DV, Rubenstein EB. Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin-11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy. Cancer. 2003; 97(12):3099-3106.","DOI":"10.1002\/cncr.11447"},{"key":"30865","doi-asserted-by":"crossref","unstructured":"Townsley DM, Scheinberg P, Winkler T. Eltrombopag added to standard immunosuppression for aplastic anemia. N Engl J Med. 2017; 376(16):1540-1550.","DOI":"10.1056\/NEJMoa1613878"},{"key":"30866","doi-asserted-by":"crossref","unstructured":"Roth M, Will B, Simkin G. 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