Romiplostim in Chemotherapy-Induced Thrombocytopenia

Inclusion Criteria: Age: 1- 18 years. Patients diagnosed with solid malignancy based on clinical, histopathological features, and /or immunohistochemical staining. Patients with chemotherapy-induced thrombocytopenia defined as either * severe thrombocytopenia either clinically with high bleeding score or laboratory by platelet count reaching critical level \< 20x10e9/L requiring platelet transfusion at time of chemotherapy cycle nadir. * delayed recovery of platelet count: a platelet count of less than 100 x10e9/L for 3 weeks from the first day of chemotherapy cycle administration or the previous dose was reduced by \>20% due to low platelet count \<100×10e9/L. Exclusion Criteria: * Patients with second primary neoplasm. * Patients with relapsed/refractory solid malignancy. * Presence of primary or metastatic liver cancer. * History of a prior symptomatic venous thromboembolic event (VTE) or arterial ischemic events. * Patients with thrombocytopenia due to other etiologies e.g., underlying inherited thrombocytopenia.