Treatment with recombinant human thrombopoietin (rhTPO) seems to be safe in patients with refractory gestational immune thrombocytopenia (ITP), according to a new study published in the Journal of International Medical Research. Moreover, subcutaneous administration of the treatment makes it a convenient option for pregnant women. 

“Thus, rhTPO may be a viable alternative treatment option for patients with refractory gestational ITP who do not respond to first-line therapies,” the study authors wrote. 

Read more about the treatment of ITP

rhTPO is a treatment option for patients with ITP, who do not respond to corticosteroids and intravenous immunoglobulin, the researchers said. However, information about its safety and efficacy in pregnant women is scarce, the authors noted.

In the present study, a team of researchers retrospectively reviewed the case of 4 patients who were diagnosed with ITP and treated with rhTPO during their pregnancy. 

The researchers reported that 2 of the patients responded to treatment with rhTPO treatment while the other 2 did not. There were no adverse events recorded in the babies of any of the women.

“Despite the apparent limitations of the present study, our findings indicate that rhTPO treatment may be safe for patients with refractory [gestational] ITP, and that subcutaneous injection is a convenient delivery method without adverse events,” the authors concluded. “A longer continuous treatment may result in greater benefits to patients.”

ITP is a rare bleeding disorder characterized by unusually low platelet counts. The first-line therapy involves corticosteroids, but most patients do not respond to this. Other options include intravenous immunoglobulin or anti-D immunoglobulin.

rhTPO has been shown in clinical studies to stimulate the production of platelets and increase peripheral platelet counts. Its safety in pregnant women is currently being investigated in clinical trials.


Yu J, Miao P, Qian S. Application of recombinant human thrombopoietin in pregnant women with immune thrombocytopenia: a single-center experience of four patients and literature review. J Int Med Res. Published online August 7, 2023. doi:10.1177/03000605231187950