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学科主题: 临床医学
题名:
Recombinant human thrombopoietin promotes platelet engraftment after haploidentical hematopoietic stem cell transplantation: a prospective randomized controlled trial
作者: Han, Ting-ting1; Xu, Lan-ping1; Liu, Dai-hong1; Liu, Kai-yan1; Wang, Feng-rong1; Wang, Yu1; Yan, Chen-hua1; Chen, Yu-hong1; Sun, Yu-qian1; Ji, Yu1; Wang, Jing-zhi1; Zhang, Xiao-hui1; Huang, Xiao-jun1,2
关键词: Recombinant human thrombopoietin ; Delayed platelet engraftment ; Hematopoietic stem cell transplantation ; Efficacy
刊名: ANNALS OF HEMATOLOGY
发表日期: 2015
DOI: 10.1007/s00277-014-2158-1
卷: 94, 期:1, 页:117-128
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology
研究领域[WOS]: Hematology
关键词[WOS]: BONE-MARROW-TRANSPLANTATION ; HUMAN MEGAKARYOCYTE GROWTH ; PHASE-I TRIAL ; C-MPL ; HEMATOLOGICAL MALIGNANCIES ; THROMBOCYTOPENIA ; CANCER ; CHEMOTHERAPY ; DEPLETION ; RECOVERY
英文摘要:

Delayed platelet engraftment (DPE) is a common complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This phenomenon is also a predictor of increased treatment-related mortality and poor survival. Therefore, therapies that promote platelet engraftment to prevent DPE are needed. This prospective randomized controlled trial was designed to investigate whether recombinant human thrombopoietin (rhTPO), administered subcutaneously at a daily dose of 15,000 U from the first day after transplantation, promotes platelet engraftment after haploidentical HSCT. The cumulative incidence of platelet engraftment (platelet recovery to a parts per thousand yen20 x 10(9)/L without transfusion support for seven consecutive days) on day 60 post-transplantation was significantly higher in the rhTPO group (n = 60) than in the control group (n = 60) (91.7 +/- 3.8 % vs. 74.5 +/- 5.8 %, P = 0.041). Additionally, the number of platelet transfusions from day 14 to day 60 was significantly lower in the rhTPO group than in the control group (4 +/- 5 vs. 7 +/- 9 Units, P = 0.018). No severe adverse effects were observed, with a median follow-up duration of 256 days (range, 48-586 days). The incidences of acute graft-versus-host disease (GVHD), chronic GVHD, and cytomegalovirus viremia and the probabilities of overall survival and disease-free survival did not differ between the two groups. A multivariate analysis of all patients revealed that regardless of assignment to the rhTPO group or the control group (hazard ratio (HR) = 1.514; 95 % CI (1.024-2.238); P = 0.038), the number of total infused CD34(+) cells (HR = 1.304; 95 % CI (1.148-1.482); P < 0.001) and slower neutrophil engraftment (HR = 2.777; 95 % CI (1.841-4.189); P < 0.001) were associated with platelet engraftment. In conclusion, rhTPO promotes platelet engraftment and safely reduces the requirement for platelet transfusion in patients after unmanipulated haploidentical HSCT. This trial was registered with the Chinese Clinical Trial (www.chictr.org) as ChiCTR-TRC-11001774. http://www.chictr.org/cn/proj/show.aspx?proj=2132.

语种: 英语
所属项目编号: 30971292 ; 30725038 ; 7122193 ; 2011AA020105
项目资助者: National Natural Science Foundation of China ; Natural Science Foundation of Beijing ; National High Technology Research and Development Program of China (Program 863) ; Clinical Subject&prime ; s Key Project of the Ministry of Health
WOS记录号: WOS:000347149100013
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58960
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China
2.Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China

Recommended Citation:
Han, Ting-ting,Xu, Lan-ping,Liu, Dai-hong,et al. Recombinant human thrombopoietin promotes platelet engraftment after haploidentical hematopoietic stem cell transplantation: a prospective randomized controlled trial[J]. ANNALS OF HEMATOLOGY,2015,94(1):117-128.
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