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Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation

Platelet graft failure (PGF) is a frequent and serious complication after Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and lacks effective treatment strategies, which could affect the prognosis of patients and even cause death. The exact underlying mechanism of PGF remains unclear,...

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Autores principales: Zhu, Lidan, Liu, Jia, Kong, Peiyan, Gao, Shichun, Wang, Lu, Liu, Huanfeng, Zhang, Cheng, Gao, Li, Feng, Yimei, Chen, Ting, Gao, Lei, Zhang, Xi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184517/
https://www.ncbi.nlm.nih.gov/pubmed/35693772
http://dx.doi.org/10.3389/fimmu.2022.910893
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author Zhu, Lidan
Liu, Jia
Kong, Peiyan
Gao, Shichun
Wang, Lu
Liu, Huanfeng
Zhang, Cheng
Gao, Li
Feng, Yimei
Chen, Ting
Gao, Lei
Zhang, Xi
author_facet Zhu, Lidan
Liu, Jia
Kong, Peiyan
Gao, Shichun
Wang, Lu
Liu, Huanfeng
Zhang, Cheng
Gao, Li
Feng, Yimei
Chen, Ting
Gao, Lei
Zhang, Xi
author_sort Zhu, Lidan
collection PubMed
description Platelet graft failure (PGF) is a frequent and serious complication after Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and lacks effective treatment strategies, which could affect the prognosis of patients and even cause death. The exact underlying mechanism of PGF remains unclear, and lacks standard treatment. Here, we conduct a retrospective study to evaluate the efficacy and safety of avatrombopag combined with mesenchymal stem cells (MSCs) in 16 patients with thrombocytopenia after allo-HSCT. Patients were administered the following treatment regimen: 20 mg/d avatrombopag; if the PLT count was less than 50×10(^)9/L for at least 2 weeks, the dose was increased to 40 mg/d; if the PLT count was 200-400×10(^)9/L, the dose was reduced; and if the PLT count was greater than 400×10^9/L, avatrombopag was terminated. Umbilical cord MSCs (1×10(^)6 cells/kg) infusion was performed every week for 4-6 weeks. Among the 16 patients, 13 patients (81.3%) achieved a complete response (CR), 2 patients (12.5%) got a partial response (PR), and 1 patient (6.3%) had no response (NR). The median time to obtain CR was 32 (7-426) days after treatment with avatrombopag combined with umbilical cord MSCs. The time to reach 20×10(^)9/L≤ PLT <50×10(^)9/L in the 2 patients with PR was 52 and 230 days after treatment, respectively. One patient had a severe pulmonary infection and died of cytomegalovirus pneumonia. Overall, our results indicated that combination of avatrombopag with MSCs can promote platelet recovery after transplantation, thereby improving the survival rate of patients and improving the quality of life of patients after transplantation, and providing a new method and strategy for the treatment of thrombocytopenia after allo-HSCT.
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spelling pubmed-91845172022-06-11 Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation Zhu, Lidan Liu, Jia Kong, Peiyan Gao, Shichun Wang, Lu Liu, Huanfeng Zhang, Cheng Gao, Li Feng, Yimei Chen, Ting Gao, Lei Zhang, Xi Front Immunol Immunology Platelet graft failure (PGF) is a frequent and serious complication after Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and lacks effective treatment strategies, which could affect the prognosis of patients and even cause death. The exact underlying mechanism of PGF remains unclear, and lacks standard treatment. Here, we conduct a retrospective study to evaluate the efficacy and safety of avatrombopag combined with mesenchymal stem cells (MSCs) in 16 patients with thrombocytopenia after allo-HSCT. Patients were administered the following treatment regimen: 20 mg/d avatrombopag; if the PLT count was less than 50×10(^)9/L for at least 2 weeks, the dose was increased to 40 mg/d; if the PLT count was 200-400×10(^)9/L, the dose was reduced; and if the PLT count was greater than 400×10^9/L, avatrombopag was terminated. Umbilical cord MSCs (1×10(^)6 cells/kg) infusion was performed every week for 4-6 weeks. Among the 16 patients, 13 patients (81.3%) achieved a complete response (CR), 2 patients (12.5%) got a partial response (PR), and 1 patient (6.3%) had no response (NR). The median time to obtain CR was 32 (7-426) days after treatment with avatrombopag combined with umbilical cord MSCs. The time to reach 20×10(^)9/L≤ PLT <50×10(^)9/L in the 2 patients with PR was 52 and 230 days after treatment, respectively. One patient had a severe pulmonary infection and died of cytomegalovirus pneumonia. Overall, our results indicated that combination of avatrombopag with MSCs can promote platelet recovery after transplantation, thereby improving the survival rate of patients and improving the quality of life of patients after transplantation, and providing a new method and strategy for the treatment of thrombocytopenia after allo-HSCT. Frontiers Media S.A. 2022-05-27 /pmc/articles/PMC9184517/ /pubmed/35693772 http://dx.doi.org/10.3389/fimmu.2022.910893 Text en Copyright © 2022 Zhu, Liu, Kong, Gao, Wang, Liu, Zhang, Gao, Feng, Chen, Gao and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Zhu, Lidan
Liu, Jia
Kong, Peiyan
Gao, Shichun
Wang, Lu
Liu, Huanfeng
Zhang, Cheng
Gao, Li
Feng, Yimei
Chen, Ting
Gao, Lei
Zhang, Xi
Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title_full Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title_fullStr Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title_full_unstemmed Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title_short Analysis of the Efficacy and Safety of Avatrombopag Combined With MSCs for the Treatment of Thrombocytopenia After Allogeneic Hematopoietic Stem Cell Transplantation
title_sort analysis of the efficacy and safety of avatrombopag combined with mscs for the treatment of thrombocytopenia after allogeneic hematopoietic stem cell transplantation
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184517/
https://www.ncbi.nlm.nih.gov/pubmed/35693772
http://dx.doi.org/10.3389/fimmu.2022.910893
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