The Efficacy of Eltrombopag Treatment in Patients who developed Platelet Engraftment Failure after Allogeneic Stem Cell Transplantation: A Single Center Experience

Abstract

Objective:Persistent thrombocytopenia is a common complication of allogeneic stem cell transplantation (ASCT). Treatment of platelet engraftment failure after ASCT remains controversial. Drugs, such as eltrombopag, are used for this purpose. Eltrombopag is an Food and Drug Administration -approved oral thrombopoietin receptor agonist. We aim to present the results of 12 patients treated with eltrombopag in our center for severe thrombocytopenia after ASCT.Methods:From January 2018 to February 2020, a total of 56 patients underwent ASCT. Twelve patients had persistent thrombocytopenia following ASCT. All patients received eltrombopag.Results:Primary platelet engraftment failure developed in six of 12 patients who developed persistent thrombocytopenia after ASCT. Secondary platelet engraftment failure developed in six of them. After eltrombopag treatment, eight (66.7%) patients achieved transfusion independence, whereas four patients (33.3%) could not. The maximum platelet count after the eltrombopag treatment was median 118.000 (range: 24,000-253,000)/μL. The median time from the start of eltrombopag until the platelet count was >50,000/ μL was 18 (range: 14-112) days. The median duration of treatment with eltrombopag was 70 (range: 26-180) days. Eltrombopag was discontinued in all patients who survived and had full platelet recovery.Conclusion:Thrombocytopenia after ASCT is a condition that should be treated as it can lead to life-threatening bleeding.

Keywords

• hematopoietic stem cell transplantation
• platelet engraftment failure
• eltrombopag