血小板生成素受体激动剂联合重组人血小板生成素与单独重组人血小板生成素对自体造血干细胞移植的多发性骨髓瘤患者造血重建的影响比较

IF 3.6 3区医学 Q2 HEMATOLOGY

Transplantation and Cellular Therapy Pub Date : 2025-02-01 DOI:10.1016/j.jtct.2024.12.015

Xuezhu Xu , Ruoyu Yang , Yachun Jia , Gongzhizi Gao , Tianyu Huang , Aili He , Fangxia Wang

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引用次数: 0

摘要

背景：Hetrombopag是一种新型的血小板生成素受体激动剂，当与重组人血小板生成素（rhTPO）联合使用时，显示出刺激血小板产生的叠加效应。但目前尚不清楚这种组合是否能促进自体干细胞移植（ASCT）后的造血重建。目的：比较重组人血小板生成素（rhTPO）联合血小板生成素受体激动剂（TPO-RA）与单独rhTPO在新诊断多发性骨髓瘤（NDMM）接受自体干细胞移植（ASCT）患者造血恢复、不良事件、术后并发症和成本效益方面的影响。方法：纳入2021年1月至2024年5月在我院连续行ASCT的67例NDMM患者。35例患者接受rhTPO联合TPO-RA造血干细胞回输治疗（观察组），32例患者单独接受rhTPO治疗（对照组）。比较两组患者造血重建情况。结果：两组的基线临床特征相似。观察组患者血小板恢复的中位时间为干细胞回输后9天，显著短于对照组（p=0.003）。观察组平均血小板输注次数显著低于对照组（1.0 vs 2.0单位，p=0.034）。所有患者对rhTPO和TPO-RA耐受良好，未观察到血栓事件。生存分析显示，添加TPO-RA后，患者的进展时间（TTP）和总生存期（OS）均未减少。两组患者不良事件发生率、药品费用、住院时间比较，差异均无统计学意义（p < 0.05）。结论：尽管样本量和研究设计限制了本研究的数据，但我们的研究结果表明，与单独使用rhTPO相比，TPO-RA （hetrombopag）与rhTPO联合使用可增强血小板恢复，且不会增加不良反应。

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Comparison of Thrombopoietin Receptor Agonists Plus Recombinant Human Thrombopoietin versus Recombinant Human Thrombopoietin Alone for Hematopoietic Reconstruction in Multiple Myeloma Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation

Background

Hetrombopag is a novel thrombopoietin receptor agonist that has shown an additive effect in stimulating platelet production when combined with recombinant human thrombopoietin (rhTPO). However, it remains unclear whether this combination can promote hematopoietic reconstruction after autologous stem cell transplant (ASCT).

Purpose

To compare the effect of rhTPO plus thrombopoietin receptor agonists (TPO-RA) versus rhTPO alone on hematopoietic recovery, adverse events, postoperative complications, and cost-effectiveness in patients with newly diagnosed multiple myeloma (NDMM) undergoing ASCT.

Methods

A total of 67 consecutive NDMM patients who underwent ASCT at our hospital from January 2021 to May 2024 were included. Of these patients, 35 received a combination of rhTPO and the TPO-RA hetrombopag after stem cell reinfusion (observation group), whereas 32 patients received rhTPO alone (control group). Hematopoietic reconstitution between the two groups was compared.

Results

Baseline clinical characteristics were similar between both groups. In the observation group, the median time to platelet recovery was 9 days after stem cell reinfusion, which was significantly shorter than that in the control group (P = .003). The mean number of platelet transfusions in the observation group was significantly lower than that in the control group (1.0 vs. 2.0 units, P = .034). All patients tolerated rhTPO and TPO-RA well, with no thrombotic events observed. Survival analysis showed no reduction in time to progression (TTP) and overall survival (OS) with the addition of TPO-RA. There were no statistical differences in the incidence of adverse events, drug expenses, and hospital stay between two groups (P > 0.05).

Conclusions

Although sample size and study design limit the data from this study, our findings suggest that the combination of TPO-RA (hetrombopag) and rhTPO enhances platelet recovery in comparison with rhTPO alone, without increasing adverse effects.

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