Takano Kosuke, Izumi Takuya, Kawamura Toshikuni, Horiuchi Toshikatsu, Kobayashi Shinichi, Sato Ken, Kimura Fumihiko
Division of Hematology, National Defense Medical College Hospital.
Department of Internal Medicine, Irumagawa Hospital.
Rinsho Ketsueki. 2022;63(3):177-181. doi: 10.11406/rinketsu.63.177.
Herein we report a case of successful treatment of secondary graft failure due to poor graft function (PGF) using eltrombopag. A 25-year-old woman with aplastic anemia (stage 3) underwent allogeneic bone marrow transplantation (BMT) from her HLA-matched brother. Neutrophil engraftment was achieved on day 17, but she remained dependent on platelet transfusion. Chimerism analysis showed complete donor type, but she also became dependent on red blood cell transfusion later. Eltrombopag was administered on day 253 after BMT, after which she exhibited hematopoietic recovery, resulting in the withdrawal of transfusion dependency. Blood counts continued to be stable after eltrombopag was discontinued. The use of eltrombopag enabled outpatient treatment and induced hematopoietic recovery without significant side effects. Eltrombopag may be an effective and safe option for PGF after BMT.
在此，我们报告一例使用艾曲泊帕成功治疗因移植物功能不良（PGF）导致的继发性移植物失败的病例。一名25岁的再生障碍性贫血（3期）女性接受了来自其HLA匹配哥哥的异基因骨髓移植（BMT）。中性粒细胞在第17天实现植入，但她仍依赖血小板输注。嵌合体分析显示完全为供体类型，但她后来也开始依赖红细胞输注。在BMT后第253天给予艾曲泊帕，此后她出现造血恢复，导致输血依赖解除。停用艾曲泊帕后血细胞计数持续稳定。艾曲泊帕的使用使得能够进行门诊治疗并诱导造血恢复，且无明显副作用。艾曲泊帕可能是BMT后PGF的一种有效且安全的选择。
