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Chemotherapy-induced thrombocytopenia (CIT) is the principal dose-limiting toxicity in patients with glioma undergoing chemotherapy, affecting up to 25% of such patients. Methods: This is a retrospective, unblinded case series. Patients undergoing chemotherapy for glioma (astrocytoma, oligodendroglioma or glioblastoma) who developed CIT were prescribed a thrombopoetin receptor agonist (TRA, i.e. eltrombopag or romiplostim). Doses were increased on a weekly basis, as required, until platelets were > 100×10/L or this goal was not achieved with maximum dosing. Chemotherapy was resumed if possible and patients were followed as long as they remained on treatment. Results: A TRA was effective for CIT in 26/27 (96%). Once treated, all patients were able to resume chemotherapy as planned. Chemotherapy was continued for a median (range) of 11 months (2-28) and patients received an additional 5625 (0-16000) mg/m of temozolomide, 0 (0-720) mg/m of lomustine and 75 (0-390) mg/kg of bevacizumab. No patients in this series stopped chemotherapy due to completion of a planned regimen. Conclusions: By using TRAs for CIT, we were able to continue chemotherapy for a longer time and at higher doses than would have been possible without this treatment. A larger series is necessary in order to determine whether this translates into improved clinical outcomes. CIT is a common problem throughout oncology, and therefore we believe that use of TRA’s for this purpose should be further investigated.

neuro-oncology

NTOX-13. THROMBOPOIETIN RECEPTOR AGONISTS ARE EFFECTIVE IN TREATING CHEMOTHERAPY-INDUCED THROMBOCYTOPENIA, IN PATIENTS WITH GLIOMAS UNDERGOING MYELOTOXIC TREATMENT