CLINICAL IMPACT OF ELTROMBOPAG-ASSOCIATED IRON CHELATION IN ADULTS WITH IMMUNE THROMBOCYTOPENIA: A MULTICENTER REAL-WORLD STUDY

Background: Eltrombopag (ELT) is an established thrombopoietin receptor agonist (TPO-RA) for chronic immune thrombocytopenia (ITP), yet accumulating translational evidence indicates clinically relevant iron-chelating activity. Adult primary ITP-focused data characterizing longitudinal iron trajectories during ELT remain limited. We assessed whether ELT exposure is independently associated with iron deficiency (ID) in routine practice. Methods: In this multicenter retrospective study, adults with ITP were evaluated with longitudinal monitoring of platelet count, ferritin, transferrin saturation (Tsat), hemoglobin (Hb), and mean platelet volume (MPV). Within-patient change was defined as the difference between baseline and follow-up (Δ). Outcomes were compared by ELT exposure and dose strata. Multivariable linear regression was used to identify independent determinants of Δ-ferritin, adjusting for age, gender, relapse status, and iron replacement therapy (IRT). Results: The cohort included 283 adults with ITP; 110 received ELT (median 25 months). ELT was associated with greater declines in ferritin and Tsat (p