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Blood, 29 October 2009, Vol. 114, No. 18, pp. 3748-3756. Prepublished online as a Blood First Edition Paper on August 11, 2009; DOI 10.1182/blood-2009-05-224766. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2009-05-224766v1 114/18/3748    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Kuter, D. J. Articles by Rutstein, M. PubMed PubMed Citation Articles by Kuter, D. J. Articles by Rutstein, M. Related Collections Free Research Articles Platelets and Thrombopoiesis Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Evaluation of bone marrow reticulin formation in chronic immune thrombocytopenia patients treated with romiplostim David J. Kuter1, Ghulam J. Mufti2, Barbara J. Bain3, Robert P. Hasserjian1, Wende Davis4, and Mark Rutstein4 1 Massachusetts General Hospital, Boston; 2 King's College Hospital, London, United Kingdom; 3 St Mary's Hospital, London, United Kingdom; and 4 Amgen Inc, Thousand Oaks, CA Romiplostim is a thrombopoietin receptor agonist that increases platelet counts in patients with chronic immune thrombocytopenia (ITP). Thrombopoietin receptor agonists are reported to increase the risk for reticulin fiber deposition within bone marrow. This report describes bone marrow findings from romiplostim-treated rats, a retrospective analysis of reticulin observed in romiplostim ITP clinical trials, and a prospective clinical study of the effects of romiplostim on bone marrow morphology. In rats, romiplostim produced a dose-dependent increase in bone marrow fibrosis that resolved after treatment withdrawal. Of 271 ITP patients in romiplostim clinical trials, 10 were reported to have reticulin deposition; reticulin grade was increased in 4 of 5 patients with both pretreatment and on-treatment bone marrow results. Reticulin grade often decreased soon after romiplostim discontinuation. In the prospective study, reticulin grade during romiplostim treatment remained within the normal range for all patients and was increased in only 1 of 6 patients with pretreatment and on-treatment bone marrow results. This report suggests that romiplostim produces reversible, dose-dependent bone marrow changes in rats and produces modest increases in bone marrow reticulin in some ITP patients that decrease when therapy is discontinued. These studies were registered at www.clinicaltrials.gov as #NCT00102323 [ClinicalTrials.gov] , #NCT00102336 [ClinicalTrials.gov] , #NCT00861224 [ClinicalTrials.gov] , and #NCT00116688 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: TPO-mimetics and myelofibrosis? A reticulin question! Michele P. Lambert Blood 2009 114: 3722-3723. [Full Text] [PDF] This article has been cited by other articles: M. P. Lambert TPO-mimetics and myelofibrosis? A reticulin question! Blood, October 29, 2009; 114(18): 3722 - 3723. [Full Text] [PDF]

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