[Impact on platelet recovery of recombinant human thrombopoietin in severe aplastic anemia patients with allogeneic hematopoietic stem cell transplantation].

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.