Bone marrow findings of patients from the retrospective analysis of reports of bone marrow reticulin in romiplostim clinical trials
| Patient ID . | Reasons for bone marrow biopsy . | Event led to treatment discontinuation, yes/no . | Peripheral blood abnormalities . | Reticulin grade assessment (weeks after initiating romiplostim) . | |||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline (months before romiplostim) . | During romiplostim treatment . | After romiplostim discontinuation . | |||||||
| First BM . | Second BM . | Third BM . | First BM . | Second BM . | |||||
| 1 | NA | Yes | Transient increased blood blasts | 0-1, focal 2 (month −4) | 3 (week 5) | — | — | 1-2 (week 17) | — |
| 2 | Vaginal bleeding | No* | — | NA | 2+ (week 40) | — | — | 2+ (week 108) | — |
| 3 | ↑ teardrop cells | Yes | — | NA | 1, focal 2 (week 45) | — | — | — | — |
| 4 | ↑ peripheral nucleated RBCs and blasts | Yes | Transient increased blood blasts | 0 (month −33) | 2-3 (week 26) | — | — | 1-2 (week 34) | 1 (week 46) |
| 5 | Prospective study protocol | No | — | 0-1 (month −6) | 0-1† (week 35) | — | — | — | — |
| 6 | ↑ nucleated RBCs | No | — | 0-1 (month −24) | 1-3‡ (week 31) | 2-3 (week 51) | 1-2 (week 67) | — | — |
| 7 | NA | No | — | NA | — | — | — | 2-3 (week 30) | — |
| 8 | NA | No | — | 1 (month −47) | 4§ (week 26) | — | — | 1-2 (week 38) | — |
| 9 | Splenomegaly | Yes | — | Positive (month −2) | Moderate (week 32) | — | — | — | — |
| 10 | NA | No | — | NA | Mild (week 135) | — | — | — | — |
| Patient ID . | Reasons for bone marrow biopsy . | Event led to treatment discontinuation, yes/no . | Peripheral blood abnormalities . | Reticulin grade assessment (weeks after initiating romiplostim) . | |||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline (months before romiplostim) . | During romiplostim treatment . | After romiplostim discontinuation . | |||||||
| First BM . | Second BM . | Third BM . | First BM . | Second BM . | |||||
| 1 | NA | Yes | Transient increased blood blasts | 0-1, focal 2 (month −4) | 3 (week 5) | — | — | 1-2 (week 17) | — |
| 2 | Vaginal bleeding | No* | — | NA | 2+ (week 40) | — | — | 2+ (week 108) | — |
| 3 | ↑ teardrop cells | Yes | — | NA | 1, focal 2 (week 45) | — | — | — | — |
| 4 | ↑ peripheral nucleated RBCs and blasts | Yes | Transient increased blood blasts | 0 (month −33) | 2-3 (week 26) | — | — | 1-2 (week 34) | 1 (week 46) |
| 5 | Prospective study protocol | No | — | 0-1 (month −6) | 0-1† (week 35) | — | — | — | — |
| 6 | ↑ nucleated RBCs | No | — | 0-1 (month −24) | 1-3‡ (week 31) | 2-3 (week 51) | 1-2 (week 67) | — | — |
| 7 | NA | No | — | NA | — | — | — | 2-3 (week 30) | — |
| 8 | NA | No | — | 1 (month −47) | 4§ (week 26) | — | — | 1-2 (week 38) | — |
| 9 | Splenomegaly | Yes | — | Positive (month −2) | Moderate (week 32) | — | — | — | — |
| 10 | NA | No | — | NA | Mild (week 135) | — | — | — | — |
NA indicates not available; BM, bone marrow examination; and —, not applicable.
Discontinued for reason other than reticulin deposition.
This patient was also evaluated in the prospective analysis.
A focal area of possible collagen deposition was seen on trichrome stain that may have been confounded by the presence of crush artifact.
Minimal collagen deposition in this sample; none on follow-up after treatment discontinuation.