重组人血小板生成素对重型再生障碍性贫血免疫抑制治疗近期疗效的影响

OBJECTIVE: To evaluate the impact of recombinant human thrombopoietin (rhTPO) on short-term response of immunosuppressive therapy (IST) in patients with newly diagnosed acquired severe aplastic anemia (SAA). METHODS: The clinical data of forty adult acquired SAA patients, who treated with IST combined with rhTPO, were retrospective analyzed and the hematologic recovery were compared with patients by the IST alone during the same period. The factors affecting the short-term response were also analyzed. RESULTS: At 3 months after IST, both the total response rate and CR+ GPR rate in rhTPO group were much higher than those in control group (75.0% vs 50.0%,P=0.022; and 17.5% vs 2.5%,P=0.025). At 6 months after IST, there was no difference of total hematologic response rate in rhTPO group and control group (77.5% vs 57.5%,P=0.058), while the CR+GPR rate was still higher in rhTPO group(45.0% vs 22.5%,P=0.033). The median time of platelet transfusion independence was much shorter in rhTPO group [33(0–90) vs 53(0–75) d,P=0.019]. Patients in rhTPO group needed less platelets transfusion support. The median platelet count in rhTPO group was 29(4–95)×10(9)/L at 3 months after IST, which was much higher than that in control group [15(5–94)×10(9)/L,P=0.006]. There was no significant difference regarding overall survival between the two groups (100.0% vs 91.0%,P=0.276). CONCLUSION: rhTPO is effective in promoting platelet recovery and improving the hematopoietic response for SAA patients with IST.