Ding Yuntian, Liu Hengyu, Wang Yaqun, Deng Haimei, Sun Yanfeng, Sun Tiantian, Wang Yin, Zeng Yunxin
Department of Hematology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Ann Hematol. 2025 Jul 9. doi: 10.1007/s00277-025-06490-z.
Delayed platelet engraftment (DPE) is a prevalent complication following umbilical cord blood transplantation (UCBT), accompanied by increased transplant-related mortality. This study aims to evaluate the efficacy, safety, and tolerability of romiplostim and recombinant human thrombopoietin (rhTPO) in enhancing platelet engraftment after UCBT. A total of 19 patients scheduled to receive UCBT were randomly assigned to the romiplostim group (250 µg once weekly from day 5 to platelet engraftment after UCBT, n = 7) or rhTPO group (300 U/kg once daily from days 5 to 18 after UCBT, n = 12). The median time of PLT engraftment was no statistical difference between rhTPO and romiplostim group: 29.5 days (range: 13-43 days) compared to 31 days (range: 23-40 days; P =.269). The median dose of romiplostim was 4 (range: 2-5 doses). Furthermore, the consumption of PLT was equivalent between the Ro group and the rhTPO group: 10 units (range: 7-26 units) and 10 units (range: 3-24 units; P =.694). All patients survived for one year and remained relapse-free. Romiplostim group had a lower incidence of acute graft versus host disease (aGvHD). No severe adverse effects were observed in any of the patients. This study demonstrated that romiplostim and rhTPO are both effective in promoting platelet engraftment after UCBT. Romiplostim was more practical and tolerable due to its cost and labor-saving benefits.
延迟血小板植入（DPE）是脐带血移植（UCBT）后常见的并发症，会增加移植相关死亡率。本研究旨在评估罗米司亭和重组人血小板生成素（rhTPO）在增强UCBT后血小板植入方面的疗效、安全性和耐受性。共有19例计划接受UCBT的患者被随机分配至罗米司亭组（从第5天开始每周一次，剂量为250μg，直至UCBT后血小板植入，n = 7）或rhTPO组（从UCBT后第5天至第18天，每日一次，剂量为300 U/kg，n = 12）。rhTPO组和罗米司亭组的血小板植入中位时间无统计学差异：分别为29.5天（范围：13 - 43天）和31天（范围：23 - 40天；P = 0.269）。罗米司亭的中位剂量为4（范围：2 - 5剂）。此外，罗米司亭组和rhTPO组的血小板消耗量相当：分别为10单位（范围：7 - 26单位）和10单位（范围：3 - 24单位；P = 0.694）。所有患者均存活一年且无复发。罗米司亭组急性移植物抗宿主病（aGvHD）的发生率较低。所有患者均未观察到严重不良反应。本研究表明，罗米司亭和rhTPO在促进UCBT后血小板植入方面均有效。由于其成本和节省人力的优势，罗米司亭更具实用性和耐受性。
