ITP characteristics and outcomes
| Patient n . | Patient age, y . | ITP phase . | N of prior treatment lines for ITP . | Tpo-RA (maximal dose during pregnancy) . | Gestation at Tpo-RA initiation, wk (treatment duration during pregnancy, wk) . | Platelet count nadir during pregnancy/platelet count before Tpo-RA/platelet count at time of delivery, × 109/L . | Bleeding manifestations/main reason for using Tpo-RA . | Pattern of initial platelet response (concomitant ITP therapy, yes or no)* . |
|---|---|---|---|---|---|---|---|---|
| 1 | 33 | Chronic | 4 (splenectomy) | Eltrombopag (50 mg) | 36 (4) | 10/10/110 | No/in preparation for delivery | CR (no) |
| 1† | 35 | Chronic | 4 (splenectomy) | Eltrombopag (25 mg) | 38 (2) | 9/15/94 | No/in preparation for delivery | CR (no) |
| 2 | 30 | Chronic | 3 | Eltrombopag (50 mg) | 8‡ (12) | 1/2/123 | Yes (skin + mucosa)/unexpected pregnancy on eltrombopag | R (yes) |
| 3 | 36 | Chronic | 2 | Eltrombopag (50 mg) | 4‡ (9) | 4/4/114 | Yes (skin)/unexpected pregnancy on eltrombopag | CR (yes) |
| 4 | 29 | Chronic | 2 | Eltrombopag (50 mg) | 33 (7) | 7/14/169 | Yes (skin + mucosa)/in preparation for delivery | CR (no) |
| 5 | 21 | Chronic | 7 (splenectomy) | Eltrombopag (75 mg) | 8‡ (12) | 50/10‡/68 | No/chronic refractory ITP, unexpected pregnancy on eltrombopag | R (no) |
| 6 | 29 | Chronic | 2 | Eltrombopag (75 mg) | 34 (5) | 8/13/23 | Yes (skin)/in preparation for delivery | NR (no) |
| 7 | 32 | Newly diagnosed | 2 | Eltrombopag (50 mg) | 27 (10) | 4/4/64 | Yes (skin)/insufficient response to steroids + IV immunoglobulin | R (no) |
| 8 | 32 | Persistent secondary ITP§ | 4 | Eltrombopag (100 mg) | 30 (4) | 1/6/136 | Yes (skin + mucosa)/refractory ITP | R (yes) |
| 9 | 33 | Chronic | 4 (splenectomy) | Romiplostim (10 μg/kg) | 39 (1) | 1/1/6 | Yes (skin)/in preparation for delivery | NR (yes) |
| 10 | 24 | Chronic | 5 (splenectomy) | Romiplostim (10 μg/kg) | 34 (6) | 12/12/250 | Yes (skin)/in preparation for delivery | CR (yes) |
| 11 | 19 | Chronic | 4 | Romiplostim (10 μg/kg) | 32 (1) | 2/15/7 | Yes (skin, mucosa)/in preparation for delivery | NR (yes) |
| 12 | 36 | Newly diagnosed | 2 | Romiplostim (7.5 μg/kg) | 37 (1) | 5/10/40 | Yes (skin + mucosa)/in preparation for delivery | CR (yes) |
| 13 | 38 | Chronic | 3 (splenectomy) | Romiplostim (3 μg/kg) | 36 (1) | 5/19/120 | Yes (skin + mucosa)/in preparation for delivery | CR (yes) |
| 14 | 29 | Newly diagnosed | 2 | Romiplostim (4 μg/kg) | 37 (1) | 17/20/21 | Yes (skin)/in preparation for delivery | CR (yes) |
| 15 | 34 | Newly diagnosed secondary ITP‖ | 7 | Romiplostim (500 μg) | 31 (3) | 3/4/367 | Yes (skin, active GI tract bleeding, hematuria)/severe refractory ITP | R (yes) |
| 15† | 37 | Chronic secondary ITP‖ | 7 | Eltrombopag (50 mg) | 36‡ (39) | 44/55/249 | No/chronic refractory secondary ITP | R (yes) |
| Patient n . | Patient age, y . | ITP phase . | N of prior treatment lines for ITP . | Tpo-RA (maximal dose during pregnancy) . | Gestation at Tpo-RA initiation, wk (treatment duration during pregnancy, wk) . | Platelet count nadir during pregnancy/platelet count before Tpo-RA/platelet count at time of delivery, × 109/L . | Bleeding manifestations/main reason for using Tpo-RA . | Pattern of initial platelet response (concomitant ITP therapy, yes or no)* . |
|---|---|---|---|---|---|---|---|---|
| 1 | 33 | Chronic | 4 (splenectomy) | Eltrombopag (50 mg) | 36 (4) | 10/10/110 | No/in preparation for delivery | CR (no) |
| 1† | 35 | Chronic | 4 (splenectomy) | Eltrombopag (25 mg) | 38 (2) | 9/15/94 | No/in preparation for delivery | CR (no) |
| 2 | 30 | Chronic | 3 | Eltrombopag (50 mg) | 8‡ (12) | 1/2/123 | Yes (skin + mucosa)/unexpected pregnancy on eltrombopag | R (yes) |
| 3 | 36 | Chronic | 2 | Eltrombopag (50 mg) | 4‡ (9) | 4/4/114 | Yes (skin)/unexpected pregnancy on eltrombopag | CR (yes) |
| 4 | 29 | Chronic | 2 | Eltrombopag (50 mg) | 33 (7) | 7/14/169 | Yes (skin + mucosa)/in preparation for delivery | CR (no) |
| 5 | 21 | Chronic | 7 (splenectomy) | Eltrombopag (75 mg) | 8‡ (12) | 50/10‡/68 | No/chronic refractory ITP, unexpected pregnancy on eltrombopag | R (no) |
| 6 | 29 | Chronic | 2 | Eltrombopag (75 mg) | 34 (5) | 8/13/23 | Yes (skin)/in preparation for delivery | NR (no) |
| 7 | 32 | Newly diagnosed | 2 | Eltrombopag (50 mg) | 27 (10) | 4/4/64 | Yes (skin)/insufficient response to steroids + IV immunoglobulin | R (no) |
| 8 | 32 | Persistent secondary ITP§ | 4 | Eltrombopag (100 mg) | 30 (4) | 1/6/136 | Yes (skin + mucosa)/refractory ITP | R (yes) |
| 9 | 33 | Chronic | 4 (splenectomy) | Romiplostim (10 μg/kg) | 39 (1) | 1/1/6 | Yes (skin)/in preparation for delivery | NR (yes) |
| 10 | 24 | Chronic | 5 (splenectomy) | Romiplostim (10 μg/kg) | 34 (6) | 12/12/250 | Yes (skin)/in preparation for delivery | CR (yes) |
| 11 | 19 | Chronic | 4 | Romiplostim (10 μg/kg) | 32 (1) | 2/15/7 | Yes (skin, mucosa)/in preparation for delivery | NR (yes) |
| 12 | 36 | Newly diagnosed | 2 | Romiplostim (7.5 μg/kg) | 37 (1) | 5/10/40 | Yes (skin + mucosa)/in preparation for delivery | CR (yes) |
| 13 | 38 | Chronic | 3 (splenectomy) | Romiplostim (3 μg/kg) | 36 (1) | 5/19/120 | Yes (skin + mucosa)/in preparation for delivery | CR (yes) |
| 14 | 29 | Newly diagnosed | 2 | Romiplostim (4 μg/kg) | 37 (1) | 17/20/21 | Yes (skin)/in preparation for delivery | CR (yes) |
| 15 | 34 | Newly diagnosed secondary ITP‖ | 7 | Romiplostim (500 μg) | 31 (3) | 3/4/367 | Yes (skin, active GI tract bleeding, hematuria)/severe refractory ITP | R (yes) |
| 15† | 37 | Chronic secondary ITP‖ | 7 | Eltrombopag (50 mg) | 36‡ (39) | 44/55/249 | No/chronic refractory secondary ITP | R (yes) |
CR, complete response; GI, gastrointestinal; NR, no response; R, response.
Includes mostly corticosteroids and/or IV immunoglobulin ± platelet transfusion.
Second pregnancy occurred in same patient.
Weeks before pregnancy (patient already receiving ELT when unplanned pregnancy occurred).
Sjögren syndrome–associated ITP.
Systemic lupus erythematosus–associated ITP with positive lupus anticoagulant, immunoglobulin G anticardiolipid antibody, and anti–β2-glycoprotein 1.