比较不同重组人TPO方案联合免疫抑制治疗对重型再生障碍性贫血近期疗效的影响

OBJECTIVE: To compare the short-term therapeutic effect of different regimens combining recombinant human thrombopoietin (rhTPO) with immunosuppressive therapy (IST) applied in severe aplastic anemia (SAA). METHODS: The clinical data of newly diagnosed adult SAA patients treated with first-line IST, including 18 patients with rhTPO daily and 43 patients with rhTPO every other day, was analyzed retrospectively. RESULTS: There was no significant difference between the basic clinical characteristics of the patients classified in different groups. The therapeutic effect was assessed 3 months and 6 months after IST. The statistical data revealed that the overall responses (OR) were not significantly different in daily group and every other day group (3 months: 50.0% vs 51.2%, P=0.934; 6 months: 77.8% vs 69.8%, P=0.525), while the good hematological response (CR+GPR) in SAA treated with rhTPO daily was significantly higher than that of patients treated with rhTPO every other day at 3 month after IST (38.9% vs 9.3%,P=0.011). RBC transfusion independence were not significantly different between the two groups after 4 weeks as well as 8 weeks treatment(4 weeks: 22.2% vs 18.6%,P=0.736; 8 weeks: 55.6% vs 46.5%,P=0.519), while platelet transfusion independence in rhTPO daily treated group was significantly higher than that in every other day group (88.9% vs 48.8%,P=0.003). In addition, there were no more adverse events observed in rhTPO daily group. CONCLUSION: It's more effective to promote hematopoietic recovery and reduce platelet transfusion dependence when rhTPO was daily used other than used every other day.