Objective: To evaluate the impact of recombinant human thrombopoietin (rhTPO) on short-term response of immunosuppressive therapy (IST) in patients with newly diagnosed acquired severe aplastic anemia (SAA).
Methods: The clinical data of forty adult acquired SAA patients, who treated with IST combined with rhTPO, were retrospective analyzed and the hematologic recovery were compared with patients by the IST alone during the same period. The factors affecting the short-term response were also analyzed.
Results: At 3 months after IST, both the total response rate and CR+GPR rate in rhTPO group were much higher than those in control group (75.0% vs 50.0%, P=0.022; and 17.5% vs 2.5%, P=0.025). At 6 months after IST, there was no difference of total hematologic response rate in rhTPO group and control group (77.5% vs 57.5%, P=0.058), while the CR+GPR rate was still higher in rhTPO group (45.0% vs 22.5%, P=0.033). The median time of platelet transfusion independence was much shorter in rhTPO group [33(0-90) vs 53(0-75) d, P=0.019]. Patients in rhTPO group needed less platelets transfusion support. The median platelet count in rhTPO group was 29(4-95)×10⁹/L at 3 months after IST, which was much higher than that in control group [29(4-95)×10⁹/L, P=0.006]. There was no significant difference regarding overall survival between the two groups (100.0% vs 91.0%, P=0.276).
Conclusion: rhTPO is effective in promoting platelet recovery and improving the hematopoietic response for SAA patients with IST.
目的: 评价重组人血小板生成素（rhTPO）对重型再生障碍性贫血（SAA）免疫抑制治疗（IST）近期疗效的影响。
方法: 回顾性分析IST联合rhTPO治疗40例成人SAA患者，以同期单用标准IST方案的患者为对照组，比较两组患者血液学反应及血小板恢复情况，并分析影响近期疗效的相关因素。
结果: IST后3个月，rhTPO组患者血液学反应率及良好血液学反应率均明显高于对照组（75.0%对50.0%，P=0.022；17.5%对2.5%，P=0.025）。IST后6个月，rhTPO组与对照组患者血液学反应率分别为77.5%和57.5%，差异无统计学意义（P=0.058），但rhTPO组良好血液学反应率高于对照组（45.0%对22.5%，P=0.033）。rhTPO组患者脱离血小板输注时间较对照组短[33(0~90)d对53(0~75)d，P=0.019]，血小板输注中位量也明显低于对照组。IST后3个月rhTPO组患者PLT中位数为29(4~95)× 109/L，明显高于对照组的15(5~94)×109/L（P=0.006)。两组患者预期3年生存率比较差异无统计学意义（100.0%对91.0%，P=0.276）。
结论: rhTPO可提高SAA的IST血液学反应率，加快血小板恢复。