, Volume 1, Issue 4, pp 239-242
Date: 10 Aug 2012

Romiplostim overcomes refractory secondary immune thrombocytopenia in a patient affected by serous ovarian carcinoma


Immune thrombocytopenia (ITP) is an autoimmune disorder that occasionally arises with neoplasms. Although often sensitive to first-line treatment, a refractory thrombocytopenia may lead to a difficult management of the patient. A patient with primary ITP who successfully underwent surgery and chemotherapy with immunoglobulins and dexamethasone for ovarian cancer has recently been reported. We report on a 71-year-old woman who developed refractory secondary ITP concomitant with an advanced serous ovarian carcinoma. The ITP responded only to the thrombopoietin receptor agonist romiplostim with an uncommon threshold effect, enabling both palliative surgery and histological diagnosis. Although thrombopoietin receptor agonists might be useful in some circumstances, their safety and efficacy for cancer patients must still be determined. Well-designed clinical trials are urgently needed to resolve this issue.