title: Rescue therapy with romiplostim for refractory primary immune thrombocytopenia during pregnancy.
abstract: BACKGROUND
  Primary immune thrombocytopenia is not a rare event during pregnancy, and it must be carefully managed to avoid hemorrhagic complications for the mother. After failure of first-line treatments, the teratogenicity and toxicity of other therapeutic agents limit the available options and treatment.
  
  
  METHODS
  We describe the cases of two pregnant patients with corticosteroid-refractory immune thrombocytopenia who were successfully treated by romiplostim, a thrombopoietin receptor agonist, without any fetal or maternal complications.
  
  
  CONCLUSIONS
  Romiplostim may represent an important alternative treatment choice during pregnancy for immune thrombocytopenia cases refractory to first-line therapy, especially because of its speed of action and high efficacy. Nevertheless, further data are required to provide definitive evidence of its safety for newborns.
authors.affiliation: Unité Fonctionnelle d'Hématologie and Département d'Obstétrique et de Gynécologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, and Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.
authors.forename: Justine
authors.initials: J
authors.lastname: Decroocq
authors.forename: Louis
authors.initials: L
authors.lastname: Marcellin
authors.forename: Camille
authors.initials: C
authors.lastname: Le Ray
authors.forename: Lise
authors.initials: L
authors.lastname: Willems
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000378:metabolism; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000378:metabolism; D011961:Receptors, Fc / Q000627:therapeutic use*; D053628:Receptors, Thrombopoietin / Q000819:agonists; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D016879:Salvage Therapy; D013926:Thrombopoietin / Q000627:therapeutic use*
chemical_list: D011961:Receptors, Fc; D053628:Receptors, Thrombopoietin; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim