Moreover, other studies confirmed the unfavorable safety profile of topotecan with dramatic hematological toxicities in the foreground (until 54%, 31%, and 54% of grade 3–4 thrombocytopenia, anemia, and neutropenia, respectively, despite G‐CSF),6, 9, 10, 11 which could represent a serious limitation for its use in a pretreated symptomatic population in real life. This evidence concerns the gene CSF3 and Thrombocytopenia.