Eltrombopag can promote platelet implantation after allogeneic hematopoietic stem cell transplantation as safely and similarly to thrombopoietin

Front Immunol. 2024 Apr 8:15:1340908. doi: 10.3389/fimmu.2024.1340908. eCollection 2024.

Abstract

Background: Eltrombopag has demonstrated efficacy in treating low platelet (PLT) levels, but it remains unclear whether eltrombopag can promote PLT engraftment after hematopoietic stem cell transplantation (HSCT).

Methods: Forty-one HSCT patients received eltrombopag 50 mg/d from +1 day until PLT >50 × 109/L or 1 month after HSCT. Fifty-one patients in the same period received thrombopoietin (TPO) to promote PLT graft after HSCT and served as a control group.

Results: A total of 51 patients who applied TPO during the same period were treated as a control. In the eltrombopag group, the median time to white blood cells (WBC) graft was 12 days (range, 10-17 days) and the PLT graft was 15 days (range, 10-30 days), whereas for the patients in the TPO group, the median time to WBC and PLT graft was 12 days (range, 9-23 days) and 15.5 days (range, 9-41 days), respectively. In the first month after HSCT, the median WBC count in the eltrombopag group was 4.41 × 109/L (range, 0.87-40.01 × 109/L) and the median PLT was 89x109/L (range, 30-401 × 109/L); the median WBC and PLT \counts in the TPO group were 4.65 × 109/L (range, 0.99-23.63 × 109/L) and 86 × 109/L (range, 5-512 × 109/L), respectively. Patients in the TPO or eltrombopag group did not experience serious side effects after drug administration, and the difference in side effects on liver and kidney function between the two groups was not statistically significant.

Conclusion: Eltrombopag is safe and similarly promotes platelet engraftment to thrombopoietin after allogeneic HSCT.

Keywords: allogeneic hematopoietic stem cell transplantation; eltrombopag; platelet engraftment; prognosis; safety; thrombopoietin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benzoates* / therapeutic use
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Hydrazines* / therapeutic use
  • Male
  • Platelet Count
  • Pyrazoles* / pharmacology
  • Pyrazoles* / therapeutic use
  • Thrombopoietin* / therapeutic use
  • Transplantation, Homologous

Substances

  • Benzoates
  • eltrombopag
  • Hydrazines
  • Pyrazoles
  • Thrombopoietin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Technology Projects of Jinan (No. 202019044); 2021 Shandong Medical Association Clinical Research Fund—Qilu Special Project; and Young scholars research of the Chinese medical association hematology—Sansheng Pharmaceutical Project.