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Hey Jennie, I actually had this come up with one of my patients last week and looked into the literature about the use of TPO agonists in this patient population. Here is an article in PBC in the pediatric population and JCO published one recently ...

I have a 19 yo with metastatic chest wall Ewing's sarcoma who has never received dose intensification due to prolonged thrombocytopenia.  Despite this, his tumor was very chemo sensitive and he had 100% necrosis and clean margins at surgical resection. ...

Thanks for that, Glen.  The main issue I have with the data is that a statistically significant improvement in outcome​ was confined to patients who had received the 'inferior' HDMTX backbone.  And there was a (non-significant) _decrement_ in outcome ...