タケバヤシ　チアキ   Takebayashi Chiaki   竹林　ちあき    所属   東邦大学  医学部 医学科（大森病院）    職種   臨床准教授
言語種別	日本語
発表タイトル	A major thrombosis event during romiplostim therapy for aplastic anemia
会議名	第87回日本血液学会学術集会
学会区分	国内学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎Takayoshi Sumi†，Susumu Ishihara†，Naoki Onda†，Junko Shinbara†，Ruka Suzuki†，Hirofumi Irita†，Ai Yoshikawa†，Daisuke Nagase†，Kota Kawada†，Yuri Fukasawa†，Tetsuo Mikami†，Naobumi Tochigi†，Chiaki Takebayashi†
発表年月日	2025/10/11
開催地 （都市, 国名）	神戸
開催期間	2025/10/10～2025/10/12
概要	(Background) Thrombosis is a known adverse event associated with thrombopoietin receptor agonists. Most reports of thrombosis related to romiplostim (ROM) involve patients with immune thrombocytopenic purpura, and such events are rare in aplastic anemia (AA). (Case) A woman in her 60s presented with anemia and thrombocytopenia. She was diagnosed with AA stage 4 and was treated with anti- thymocyte globulin + cyclosporine + eltrombopag (EPAG). The anemia and thrombocytopenia remained transfusion- dependent, so EPAG was replaced with ROM. She achieved a trilineage response, and the dose was gradually tapered. 18 months later from ROM initiation, she presented with weakness and coldness in her left upper extremity. Blood tests showed an elevated D- dimer and FDP. Contrast- enhanced CT was performed revealing thrombi in pulmonary arteries, in the deep vein of the lower limb, and along the wall of the aorta including aortic arch. She was started on anticoagulation therapy, and her symptoms gradually improved, with a corresponding decrease in D- dimer levels. (Discussion) In previous clinical trials or Pub med searches, no thrombotic events associated with ROM in patients with AA have been reported. In cases where ROM are effective, there may be a possibility of thrombosis occurring even in AA. Regular testing for D- dimer or FDP is important, and when either of them increases, screening for both venous and arterial thrombosis is necessary. It is also crucial to taper ROM promptly once a sufficient response has been achieved.