Eltrombopag is an orally bioavailable, small molecule acting as a TPO-R agonist, approved for the treatment of thrombocytopenia of chronic immune thrombocytopenic purpura, chronic hepatitis C virus infection, and for acquired severe aplastic anemia.12,13 In higher-risk MDS, the addition of eltrombopag to azacitidine resulted in worse PLT recovery and increased progression to AML.14 This evidence concerns the gene MPL and acute myeloid leukemia.