[Impact on platelet recovery of recombinant human thrombopoietin in severe aplastic anemia patients with allogeneic hematopoietic stem cell transplantation]
- PMID: 29562465
- PMCID: PMC7342989
- DOI: 10.3760/cma.j.issn.0253-2727.2018.03.007
[Impact on platelet recovery of recombinant human thrombopoietin in severe aplastic anemia patients with allogeneic hematopoietic stem cell transplantation]
Abstract
Objective: To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×109/L, PLT ≥50×109/L, and PLT ≥100×109/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed. Results: There were no significant differences in the recovery of granulocytes and PLT ≥20×109/L among the three groups (P>0.05). The time of PLT ≥50×109/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×109/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events. Conclusion: rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.
目的: 分析重组人血小板生成素(rhTPO)促进重型再生障碍性贫血(SAA)患者异基因造血干细胞移植(allo-HSCT)后血小板恢复的疗效及安全性。 方法: 对2010年1月至2017年3月期间85例接受allo-HSCT治疗的SAA患者进行回顾性分析。根据移植后升血小板药物的使用情况,将85例患者分为rhTPO组(29例)、rhIL-11组(27例)和空白组(29例),比较三组PLT≥20×109/L、PLT≥50×109/L、PLT≥100×109/L的恢复时间以及移植后(25±5)d骨髓巨核细胞计数、移植期间血小板输注量,观察药物不良反应。 结果: rhTPO、rhIL-11、空白组粒细胞植入和PLT≥20×109/L的中位时间差异均无统计学意义(P>0.05)。rhTPO组PLT≥50×109/L时间短于空白组[16.5(11~39)d对22(14~66)d,P<0.05];rhTPO组PLT≥100×109/L时间[23(12~51)d]短于rhIL-11组[28(12~80)d]及空白组[35(18~86)d](P<0.05)。rhTPO组移植期间血小板输注量少于rhIL-11组及空白组[分别为20(10~30)、30(10~50)、35(10~70)U,P<0.05]。rhTPO、rhIL-11、空白组移植后(25±5)d骨髓巨核细胞中位计数分别为31.5(0~200)、12(0~142)、11(0~187)个,rhTPO组与rhIL-11组比较差异有统计学意义(P<0.05),rhIL-11组与空白组比较差异无统计学意义(P>0.05)。多因素分析显示,应用rhTPO是影响血小板恢复的独立影响因素[HR=4.01(95%CI 1.81~8.97),P=0.010]。rhTPO组未见明显不良反应。 结论: rhTPO可以促进SAA患者allo-HSCT后血小板恢复、减少血小板输注量,并且安全性较好。.
Keywords: Anemia, aplastic; Hematopoietic stem cell transplantation; Platelet transfusion; Thrombopoietin.
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