Comparison of the real-world efficacy and safety of romiplostim and recombinant human thrombopoietin (rhTPO) in chemotherapy-induced thrombocytopenia

OBJECTIVE: This study retrospectively compared the efficacy and safety of romiplostim and recombinant human thrombopoietin (rhTPO) in managing chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumours, aiming to provide valuable evidence for clinical practice in CIT management. METHODS: A retrospective cohort study involving patients with solid tumours who received either romiplostim or rhTPO following anticancer treatment was conducted at Nanjing Second Hospital from January 2024 to May 2025. The primary outcomes assessed were platelet recovery, treatment efficacy, and recovery time, whereas the secondary outcomes included chemotherapy adherence and the incidence of adverse events. RESULTS: A total of 68 patients were included in the analysis, among whom 32 received romiplostim and 36 received rhTPO. Baseline characteristics were comparable between the two groups. Romiplostim demonstrated a higher treatment efficacy (71.9%) than rhTPO (63.9%) ,although this difference was not statistically significant(P = 0.239). The median platelet recovery time was shorter in the romiplostim group (9 days) than in the rhTPO group (12 days) (P = 0.012). Platelet recovery to ≥ 100 × 10⁹/L was achieved by 62.5% of the romiplostim patients versus 44.4% of the rhTPO patients (P = 0.137). Furthermore, a higher proportion of patients in the romiplostim group (90.6% vs. 83.3% with rhTPO) were able to continue scheduled chemotherapy, although this difference did not reach statistical significance (P = 0.376). The incidence of adverse events was similar between the two groups, although it was lower in the romiplostim group. CONCLUSION: Compared with rhTPO, romiplostim significantly shortened the time to platelet recovery and required fewer administrations. Overall safety was comparable between the two groups, with no new safety concerns identified. Future prospective studies are warranted to confirm long-term outcomes.