Abstract
RATIONALE: Cancer therapy-induced thrombocytopenia (CTIT) is a frequent complication in cancer treatment, with severe cases posing risks of bleeding and hindering therapeutic progress. PATIENT CONCERNS: A breast cancer patient developed refractory CTIT following multiple lines of chemotherapy. Despite treatment with various thrombopoietic agents, including recombinant human thrombopoietin, eltrombopag, avatrombopag, steroids, and platelet transfusions, platelet counts remained below 50 × 109/L, with a nadir of 6 × 109/L. DIAGNOSES: Bone marrow biopsies revealed an absence of megakaryocytes, supporting the diagnosis of CTIT. INTERVENTIONS: The patient received 2 doses of romiplostim N01. OUTCOMES: The romiplostim N01 resulted in a rapid and sustained normalization of platelet counts. Platelet levels were maintained between 251 × 109/L and 304 × 109/L during follow-up, allowing uninterrupted anticancer therapy and achieving stable disease for the primary tumor. LESSONS: Romiplostim N01 effectively managed refractory CTIT in this case, showing rapid and sustained platelet recovery. This case demonstrates the potential of romiplostim N01 as a potential effective treatment for refractory CTIT.