Clinical and Applied Thrombosis/Hemostasis (Jan 2022)

Efficacy of Recombinant Human Thrombopoietin for the Treatment of Secondary Failure of Platelet Recovery After Allogeneic HSCT

  • Yigeng Cao MD,
  • Mingyang Wang MM,
  • Biao Shen MM,
  • Fei Zhao MM,
  • Rongli Zhang MD,
  • Xin Chen MM,
  • Yi He MD,
  • Weihua Zhai MD,
  • Qiaoling Ma MM,
  • Jialin Wei MM,
  • Yong Huang MD,
  • Donglin Yang MD,
  • Aiming Pang MD,
  • Sizhou Feng MD,
  • Erlie Jiang MD,
  • Mingzhe Han MD

DOI
https://doi.org/10.1177/10760296211068037
Journal volume & issue
Vol. 28

Abstract

Read online

Secondary failure of platelet recovery (SFPR) is a life-threatening complication that may affect up to 20% of patients after allogeneic hematopoietic stem cell transplantation (HSCT). In this study, to evaluate the efficacy of recombinant human thrombopoietin (rhTPO), we retrospectively analyzed 29 patients who received continuous rhTPO for the treatment of SFPR. Overall response and complete response were observed in 24 (82.8%) patients and 10 (34.5%) patients, at a median time of 21.5 days (range, 3-41 days) and 39.5 days (range, 7-53 days) after initiation of rhTPO treatment, respectively. Among the responders, the probability of keeping overall response and complete response at 1 year after response was 77.3% and 80.0%, respectively. In multivariate analysis, higher CD34 + cells (≥3 × 10 6 /kg) infused during HSCT (HR: 7.22, 95% CI: 1.53-34.04, P = 0.01) and decreased ferritin after rhTPO treatment (HR: 6.16, 95% CI: 1.18-32.15, P = 0.03) were indicated to associate with complete response to rhTPO. Importantly, rhTPO was well tolerated in all patients without side effects urging withdrawal and clinical intervention. The results of this study suggest that rhTPO may be a safe and effective treatment for SFPR.