Sniffing out the aroma(tase) of drug-induced thrombocytopenia

Abstract

In this issue of Blood, Tochigi et al made it their mission to understand the molecular mechanisms by which immunomodulatory drugs (IMiDs) induce thrombocytopenia. The authors use a combination of in vitro and ex vivo methods to show that treatment regimens, including IMiDs in multiple myeloma (MM), lead to aromatase degradation in human megakaryocytes. This has an impact on the estradiol signaling required for proplatelet formation, thus resulting in thrombocytopenia (see figure).