How do you approach chemotherapy-induced thrombocytopenia in patients who do not respond adequately to romiplostim?

That's definitely a difficult and highly nuanced clinical scenario, especially since it can hamper future delivery of chemotherapy and compromise disease outcomes. My approach to this question also depends on whether we are talking about patients with a hematologic or solid tumor malignancy. I will focus on hematologic malignancies for now; however, in either situation, I pursue a bone marrow examination to determine disease status and also to search for other marrow pathologies. If there is cle...