Successful Treatment of Aplastic Anemia With Eltrombopag During Pregnancy: A Short Report

Introduction: Aplastic anemia (AA) is a rare bone marrow failure syndrome with pancytopenia, mainly due to immune-mediated stem cell destruction. First-line therapy for acquired severe AA ≥ 50 years/non-severe AA (NSAA) requiring treatment is immunosuppressive therapy with horse anti-thymocyte globulin, cyclosporine A (CSA), and eltrombopag (EPAG). In pregnancy, cytopenia may worsen, while therapeutic options are limited. Results: We report the first case of a pregnant patient with NSAA/PNH receiving full-dose EPAG (150 mg/d). Counts remained stable, delivery was uneventful, and the child was healthy. Postpartum, EPAG was discontinued, CSA tapered, and transfusion independence achieved. Conclusion: EPAG may represent a feasible option in selected pregnancies.