Hi Birgitta-A,
for not mentioning increased bone marrow fibrosis in the MDS-Romiplostim-Studies there might be the reason, that there have been already cases for chronic ITP with this complication, that this has caused some excited discussion and that the results of a possible investigation in relation to MDS could bring a sort of face-loss for Romiplostim in frightening the public, - but while on the other side Romiplostin could be helpful for many patients with no other options.
Adam Cuker and Charles S. Abrams commented critically at the lack of bone marrow biopsies before and after study-treatment with Romiplostin, which analyses could lead to a better understanding of the mechanisms of causing fibrotic changes by Romiplostin..
http://bloodjournal.hematologylibrar...urcetype=HWCIT
So i estimated that the near future will perhaps not bring analyses with informations. Romiplostim seems helpful in augmenting the Thrombocytes, and the MDS - patients with no other choices will be thankful for it and cope with problematic side - and longterm - effects..
As the MDs- Patients are in a special danger of converting to AML, this is an other reason to be cautious and hope for better study-informations, which do more exactly describe the group of MDS-Patients in danger to convert to AML by intake of Romiplostim. Changes by Romiplostim can seemlngly happen in a fast way, like in the old mans thrombocytopenia, where the platelets increased very, very fast in a few days, - or the lower Risk- MDs-Patients converting to AML within a short time (4 Weeks study time?)..
Regards,
Margarete