Zhang Li, Yang Wenrui, Ye Lei, Zhou Kang, Jing Liping, Li Yang, Li Yuan, Li Jianping, Peng Guangxin, Song Lin, Zhao Xin, Wu Zhijie, Zhang Fengkui
Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2015 Mar;36(3):181-5. doi: 10.3760/cma.j.issn.0253-2727.2015.03.002.
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).
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.
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).
rhTPO is effective in promoting platelet recovery and improving the hematopoietic response for SAA patients with IST.
评估重组人血小板生成素（rhTPO）对新诊断的获得性重型再生障碍性贫血（SAA）患者免疫抑制治疗（IST）短期反应的影响。
回顾性分析40例接受IST联合rhTPO治疗的成人获得性SAA患者的临床资料，并与同期仅接受IST治疗的患者的血液学恢复情况进行比较。还分析了影响短期反应的因素。
IST治疗3个月时，rhTPO组的总有效率和CR+GPR率均显著高于对照组（75.0%对50.0%，P=0.022；17.5%对2.5%，P=0.025）。IST治疗6个月时，rhTPO组和对照组的总血液学缓解率无差异（77.5%对57.5%，P=0.058），但rhTPO组的CR+GPR率仍较高（45.0%对22.5%，P=0.033）。rhTPO组血小板输注独立的中位时间明显缩短[33（0-90）天对53（0-75）天，P=0.019]。rhTPO组患者需要的血小板输注支持较少。IST治疗3个月时，rhTPO组的中位血小板计数为29（4-95）×10⁹/L，明显高于对照组[29（4-95）×10⁹/L，P=0.006]。两组的总生存率无显著差异（100.0%对91.0%，P=0.276）。
rhTPO可有效促进SAA患者接受IST治疗时的血小板恢复并改善造血反应。
