PB2353 RECOMBINANT HUMAN THROMBOPOIETIN DECREASE THE NUMBER OF PLATELET TRANSFUSIONS AFTER AUTOLOGOUS STEM CELL TRANSPLANTATION
Authors: H. Wang, S. Li, J. Li, Y. Li, Z. Liu
Journal: HemaSphere (2019)

Background: Autologous stem cell transplantation (ASCT) is the main therapy regime for malignant hematology disease, such as lymphoma and multiple myeloma. Thrombocytopenia and platelet engraftment failure are known to have a poor prognosis in ASCT. Prevent hemorrhage and thrombocytopenia are important. While, there are no standard prevention treatment for these complications. Recombinant human thrombopoietin (rhTPO) is a novel agent for thrombocytopenia. Recent studies showed that rhTPO promotes platelet engraftment and represent a therapeutic option for prolonged isolated thrombocytopenia after allogeneic hematopoietic stem cell transplantation. However, the effect of rhTPO is still unclear in ASCT. Therefore, we analyzed the clinical data of patients with ASCT, and studied the effect of rhTPO after ASCT. Aims: The purpose of this study was to investigate the effect of rhTPO after ASCT, and analyze the appropriate population and provide theoretical basis for this. Methods: We collected the clinical index of 59 patients who received autologous transplantation in Shengjing hospital of China Medical University from January 2012 to January 2018. It is a retrospectively study. The patients were divided into two groups according to the usage of rhTPO: the treated group (n = 30) and the untreated group (n = 29). SPSS 23.0 was used for analysis; Chi-square test was used for count data. The OS rates were calculated by Kaplan-Meier curves. Long-rank and Breslow test methods were used for comparison of survival between groups. P values less than 0.05 were considered to indicate statistical significance. Results: 1. The median day of platelet engraftment (platelet recovery to ≥20 × 109/L without transfusion for seven consecutive days) in treated group and untreated group are: platelet implant of 10 (9-12) days and 10 (9-12) days, respectively (p = 0.562). Granulocyte engraftment (neutrophils recovery to ≥0.5 × 109/L for three consecutive days): 11 (10-12) days and 10 (9-11) days (p = 0.172), platelet recovery to 50 × 109/L: 15.5 (14-25) days and 15 (13-31) days (p = 0.819), platelet recovery to 100 × 109/L: 52 (16-105) days and 50 (17-123) days (p = 0.404), the median number of platelet transfusion: 2.5 (2-3) units and 3 (2-4) units (p = 0.044). 2. Treated group and untreated group: Transplant related mortality (TRM) (6.60% vs. 6.80%, p = 0.972), 1-year overall survival (OS) (96.70% vs.90%, p = 0.276), 1-year progression free survival (PFS) (72.70% vs. 82.80%, p = 0.447), 3-year OS (83.40% vs.81%, p = 0.798), 3-year PFS (51.90% vs.74.90%,p = 0.214), 5-year OS (83.40% vs.81%, p = 0.798), 5-year PFS (51.90% vs.59.90%, p = 0.228) 3.We analyzed gender, age, body weight, platelet count before ASCT, disease status before ASCT, mononuclear cells (MNC), CD34+ cells, and all these indexes had no significant statistical difference between treated and untreated groups on platelet engraftment, granulocyte engraftment, platelet recovery to 50 × 109/ L, platelet recovery to 100 × 109/L and number of platelet transfusions (p > 0. 05). The median amount of platelet transfusion of lymphoma patients with ASCT were 2 (2-3) units and 4 (3-5) units in treated and untreated group, respectively (p = 0.008). Summary/Conclusion: 1. The application of rhTPO in patients with ASCT showed no impact on hematopoietic reconstruction and platelet recovery, but decreased platelet transfusion. 2. The application of rhTPO with ASCT had no adverse events, and had same TRM, OS and PFS. 3. Lymphoma patients treated with rhTPO after ASCT required less platelet transfusion.