重组人血小板生成素对重型再生障碍性贫血患者异基因造血干细胞移植后血小板恢复的影响

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 ≥20×10(9)/L, PLT ≥50×10(9)/L, and PLT ≥100×10(9)/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 ≥20×10(9)/L among the three groups (P>0.05). The time of PLT ≥50×10(9)/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 ≥100×10(9)/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.