{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:16:46Z","timestamp":1790983006936,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>All-trans retinoic acid (ATRA) combined with arsenic trioxide (ATO) is a first-line treatment regimen for acute promyelocytic leukemia (APL), with generally milder myelosuppressive effects compared with conventional chemotherapy. Although standard-dose ATO is not typically considered a major risk factor for cancer treatment-induced thrombocytopenia (CTIT), severe and persistent thrombocytopenia may still occur during ATO maintenance therapy, and its clinical characteristics and therapeutic strategies remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 60-year-old female patient with APL developed refractory grade 3\u20134 thrombocytopenia during ATO maintenance therapy, with no significant response to recombinant human thrombopoietin or hetrombopag treatment (platelet nadir: 8 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L; duration of platelet count &amp;lt;50 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L: 8 weeks). Subsequently, romiplostim (250 \u03bcg\/week) was administered, resulting in platelet recovery to 151 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L within 3 weeks, accompanied by restoration of megakaryocyte numbers and reappearance of platelet-producing megakaryocytes in the bone marrow. The patient subsequently resumed maintenance therapy and completed the remaining treatment cycles with romiplostim support, maintaining continuous molecular remission during follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that refractory CTIT characterized by predominant megakaryocytic involvement may occur during ATO maintenance therapy, with clinical features potentially differing from those of conventional cytotoxic chemotherapy-related CTIT. Romiplostim may promote the recovery of residual megakaryopoietic capacity and provide a potential therapeutic option for such patients. However, its precise mechanism of action and the patient populations most likely to benefit require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1915786","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:43:36Z","timestamp":1787719416000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Romiplostim for cancer treatment-induced thrombocytopenia in acute promyelocytic leukemia: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaoye","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qixin","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1038\/s41408-021-00514-3","article-title":"Acute promyelocytic leukemia current treatment algorithms","volume":"11","author":"Yilmaz","year":"2021","journal-title":"Blood Cancer J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024026186","article-title":"Acute promyelocytic leukemia: Long-term outcomes from the Harmony 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