埃尔特罗姆波巴格改善了骨髓移植后的血小板移植:第二阶段研究的结果
Sairah Ahmed1,2, Qaiser Bashir1, Roland L Bassett3
1Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
American journal of hematology
|February 5, 2024
概括
埃尔特罗姆波帕格显著改善了使用骨髓移植和移植后循环胺的顺序性干细胞移植 (haplo-HSCT) 后的血小板恢复. 这种血栓形成素受体激动剂增强了血小板移植,减少了恢复时间,但没有增加不良事件或影响生存结果.
科学领域:
- 血液学 血液学 血液学
- 移植免疫学 移植免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 血小板恢复缓慢是一个常见的并发症,随着骨髓移植和移植后循环胺 (PCy) 预防,随着 haploidentical 造血干细胞移植 (haplo-HSCT) 后.
- 血小板恢复延迟可能需要频繁的输血,并对患者的结果产生负面影响.
研究的目的:
- 为了评估eltrombopag的安全性和有效性,一个血栓形成素受体激动剂,在加速血小板恢复后haplo-HSCT.
- 评估ELTROMBOPAG对接受HAPLO-HSCT的患者关键临床结果的影响.
主要方法:
- 一项前性研究涉及成年患者接受骨髓移植和PCy预防的Haplo-HSCT.
- 患者从移植后的+5日开始接受eltrombopag (300毫克/天).
- 血小板移植 (>50,000/μL到第60天) 是主要终点;一项后期分析将结果与匹配的对照组进行了比较.
主要成果:
- 在接受eltrombopag的患者中,73%的患者在第60天达到>50,000/μL血小板计数,而对照组的这一比例为50% (p=0.043).
- 血小板恢复的中位时间 (>20,000/μL) 与eltrombopag较短 (29天与31天,p=0.022),累计发病率较高 (90%与67.5%,p=0.014).
- 没有观察到与eltrombopag相关的≥4级不良事件. 总体存活率,无进展存活率,GVHD,复发和非复发死亡率在各组之间相似.
结论:
- 埃尔特罗姆波帕格是一种安全有效的药物,可增强血小板恢复,用于接受骨髓移植和PCy的哈普洛-HSCT患者.
- 使用eltrombopag可以改善血小板移植,减少血小板恢复的时间,而不会影响其他关键的临床结果.
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