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Eltrombopag is an effective and safe therapy for refractory thrombocytopenia after haploidentical hematopoietic stem cell transplantation
- Source :
- Bone Marrow Transplantation. 54:1310-1318
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Refractory thrombocytopenia is a frequent and severe complication after haploidentical allogeneic hematopoietic stem cell transplantation (haplo-HSCT) and lacks effective treatment strategies. Eltrombopag has shown promising results in several thrombocytopenia disorders. We report 38 patients treated with eltrombopag for refractory thrombocytopenia after haplo-HSCT. Eight patients had delayed platelet engraftment, 15 patients had secondary failure of platelet recovery, and 15 patients had poor graft function (PGF). Eltrombopag was initiated at 25 or 50 mg daily, and the dosage was adjusted to a maximum of 50–100 mg daily to maintain platelet between 50 × 109/L and 100 × 109/L. The cumulative incidence of platelet recovery to transfusion independence was 63.2% and to ≥50 × 109/L without transfusion support was 52.3%. Furthermore, neutrophil counts and hemoglobin were also increased in the nine responders with PGF. Nineteen (79.2%) of the 24 responders were able to taper off eltrombopag, and the remaining 5 patients were able to begin a taper. The median duration of treatment was 64 (range 14–195) days. The presence of megakaryocyte before initiation was the only independent factor influencing the efficacy of eltrombopag (P = 0.044). Eltrombopag was well tolerated in all patients. In summary, eltrombopag was a safe and effective therapy for refractory thrombocytopenia after haplo-HSCT.
- Subjects :
- Adult
Male
medicine.medical_specialty
Transplantation Conditioning
Adolescent
Platelet Engraftment
medicine.medical_treatment
Eltrombopag
Hematopoietic stem cell transplantation
Benzoates
Gastroenterology
Young Adult
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Megakaryocyte
hemic and lymphatic diseases
Internal medicine
Humans
Medicine
Platelet
Cumulative incidence
Refractory Thrombocytopenia
Child
Transplantation
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Thrombocytopenia
Hydrazines
Treatment Outcome
medicine.anatomical_structure
chemistry
030220 oncology & carcinogenesis
Transplantation, Haploidentical
Pyrazoles
Female
business
030215 immunology
Subjects
Details
- ISSN :
- 14765365 and 02683369
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Bone Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....3007418617e38ccad29a2182ca5d0441