2026-08-12T20:33:51Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/226892024-11-29T03:21:19Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Bento, Leyre author Maria Bastida, Jose author Garcia-Cadenas, Irene author Garcia-Torres, Estefania author Rivera, Daniel author Bosch-Vilaseca, Anna author de Miguel, Carlos author Martinez-Munoz, Maria Esther author Fernandez-Aviles, Francesc author Roldan, Elisa author Chinea, Anabelle author Yanez, Lucrecia author Zudaire, Teresa author Pinho Vaz, Carlos author Espigado, Ildefonso author Lopez, Javier author Valcarcel, David author Duarte, Rafael author Cabrera, Rafael author Herrera, Concepcion author Ramon Gonzalez-Porras, Jose author Gutierrez, Antonio author Solano, Carlos author Sampol Mayol, Antonia author GETH author 2019-09 Persistent thrombocytopenia is a common complication after allogeneic hematopoietic stem cell transplantation (allo-SCT). Romiplostim and eltrombopag are the currently available thrombopoietin receptor agonists (TPO-RAs), and some studies with very small numbers of cases have reported their potential efficacy in the allo-SCT setting. The present retrospective study evaluated the safety and efficacy of TPO-RAs in 86 patients with persistent thrombocytopenia after allo-HSCT. Sixteen patients (19%) had isolated thrombocytopenia (PT), and 71 (82%) had secondary failure of platelet recovery (SFPR). TPO-RA therapy was started at a median of 127 days (range, 27 to 1177 days) after allo-SCT. The median initial and maximum administered doses were 50 mg/day (range, 25 to 150 mg/day) and 75 mg/day (range, 25 to 150 mg/day), respectively, for eltrombopag and 1 mu g/kg (range, 1 to 7 mu g/kg) and 5 mu g/kg (range, 1 to 10 mu g/kg), respectively, for romiplostin. The median platelet count before initiation of TPO-RA therapy was 14,000/mu L (range, 1000 to 57,000/mu L). Platelet recovery to >= 50,000/mu L without transfusion support was achieved in 72% of patients at a median time of 66 days (range, 2 to 247 days). Eighty-one percent of the patients had a decreased number of megakaryocytes before treatment, showing a slower response to therapy (P=.011). The median duration of treatment was 62 days (range, 7 to 700 days). Grade 3-4 adverse events (hepatic and asthenia) were observed in only 2% of the patients. At last follow-up, 81% of patients had discontinued TPO-RAs and maintained response, and 71% were alive. To our knowledge, this is the largest series analyzing the use of TPO-RAs after allo-SCI reported to date. Our results support the efficacy and safety in this new setting. Further prospective trials are needed to increase the level of evidence and to identify predictors of response. Bento L, Maria Bastida J, Garcia-Cadenas I, Garcia-Torres E, Rivera D, Bosch-Vilaseca A, et al. Thrombopoietin Receptor Agonists for Severe Thrombocytopenia after Allogeneic Stem Cell Transplantation: Experience of the Spanish Group of Hematopoietic Stem Cell Transplant. Biol Blood Marrow Transplant. 2019 Sep;25(9):1825-31. Epub 2019 May 29. 10.1016/j.bbmt.2019.05.023 1523-6536 1083-8791 Biology of Blood and Marrow Transplantation http://hdl.handle.net/20.500.13003/17260 31152794 L2002180686 2-s2.0-85067985785 https://hdl.handle.net/20.500.12105/22689 488887800016 Thrombocytopenia Allogeneic stem cell transplantation Thrombopoietin receptor agonists Thrombopoietin Receptor Agonists for Severe Thrombocytopenia after Allogeneic Stem Cell Transplantation: Experience of the Spanish Group of Hematopoietic Stem Cell Transplant