Yıl: 2022 Cilt: 39 Sayı: 2 Sayfa Aralığı: 103 - 108 Metin Dili: İngilizce DOI: 10.4274/tjh.galenos.2022.2021.0675 İndeks Tarihi: 07-06-2022

Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation

Öz:
Objective: This study aimed to evaluate the efficacy and safety of eltrombopag (ELT) in the treatment of thrombocytopenia following hematopoietic stem cell transplantation (HSCT). Materials and Methods: Forty-eight patients treated with ELT for thrombocytopenia after allogeneic or autologous transplantation at the Erciyes University Bone Marrow Transplantation Center between July 2017 and July 2021 were evaluated retrospectively. Results: Forty-eight HSCT recipients were included in this study. Thirty (62.5%) patients were evaluated as having experienced delayed platelet recovery (DPR) and 18 (37.5%) patients as having experienced secondary failure of platelet recovery (SFPR). The median platelet count before ELT treatment was 13x109 /L (range: 3-20x109 /L). Twentythree patients responded to treatment and the cumulative incidence of successful platelet recovery was 48%. Patients with both DPR and SFPR responded, but patients with DPR had a higher response rate (50% vs. 44%). The median platelet count of the 23 responding patients was 12x109 /L (5-19x109 /L) before treatment and 68x109 /L (52-266x109 /L) after treatment (p<0.0001). While the number of bone marrow megakaryocytes before treatment was adequate in 22 (46%) cases, it was decreased in 26 (54%) cases. Patients with adequate bone marrow megakaryocytes had a better response rate than those without (77% vs. 23%, p<0.0001). The group with adequate megakaryocytes responded to treatment at a median of 33 days (range: 9-174 days). Patients with decreased megakaryocytes responded at a median of 55 days (30-164 days) (p=0.002). No drug-related side effects were observed in any patients. Conclusion: This real-life experience demonstrates that ELT is an effective and safe treatment option for thrombocytopenia after HSCT. The adequacy of bone marrow megakaryocytes before ELT treatment was an important factor affecting response to treatment.
Anahtar Kelime:

Hematopoetik Kök Hücre Nakli Sonrası Trombositopeni Tedavisinde Eltrombopag Kullanımı

Öz:
Amaç: Transplantasyon sonrası trombositopeni tedavisinde eltrombopagın (ELT) etkinlik ve güvenliğini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Erciyes Üniversitesi Kemik İliği Nakil Merkezi’nde Temmuz 2017-Temmuz 2021 tarihleri arasında allojenik veya otolog transplantasyon sonrası trombositopeni nedeniyle ELT ile tedavi edilen 48 hasta retrospektif olarak değerlendirildi. Bulgular: Bu çalışmaya 48 hematopoietik kök hücre nakli (HKHN) alıcısı dahil edildi. Otuz (%62,5) hasta gecikmiş trombosit iyileşmesi (DPR) ve 18 (%37,5) hasta ikincil trombosit iyileşme başarısızlığı (SFPR) olarak değerlendirildi. ELT tedavisinden önce medyan trombosit sayısı 13x109 /L (aralık, 3-20x109 /L) idi. Yirmi üç hasta tedaviye yanıt verdi ve başarılı trombosit iyileşmesinin kümülatif insidansı %48 idi. Hem DPR hem de SFPR’li hastalar yanıt verdi, ancak DPR’li hastalarda yanıt oranı daha yüksekti (%50’ye karşı %44). Yanıt veren 23 hastanın medyan trombosit sayısı tedaviden önce ve sonra 12 (5-19)x109 /L ve 68 (52- 266)x109 /L idi (p<0,0001). Tedavi öncesi kemik iliği megakaryosit sayısı 22 (%46) hastada yeterli iken 26 (%54) hastada azalmıştı. Yeterli kemik iliği megakaryositleri olan hastalar, azalmış olanlara göre daha iyi bir yanıt oranına sahipti (%77’ye karşı %23, p<0,0001). Yeterli megakaryositleri olan grup, tedaviye medyan 33 (aralık, 9-174) günde yanıt verdi. Megakaryositleri azalmış hastalar, ortalama 55 (aralık, 30- 164) gün yanıt verdi (p=0,002). Hiçbir hastada ilaca bağlı yan etki gözlenmedi. Sonuç: Bu gerçek yaşam deneyimi, ELT’nin HKHN sonrası trombositopeni için etkili ve güvenli bir tedavi seçeneği olduğunu göstermektedir. ELT tedavisi öncesi kemik iliği megakaryositlerinin yeterliliği tedaviye yanıtı etkileyen önemli bir faktördü.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Guven Z, ÇELİK S, Eser B, ÇETİN M, ÜNAL A, Kaynar L (2022). Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. , 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
Chicago Guven Zeynep Tugba,ÇELİK Serhat,Eser Bülent,ÇETİN Mustafa,ÜNAL Ali,Kaynar Leylagul Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. (2022): 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
MLA Guven Zeynep Tugba,ÇELİK Serhat,Eser Bülent,ÇETİN Mustafa,ÜNAL Ali,Kaynar Leylagul Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. , 2022, ss.103 - 108. 10.4274/tjh.galenos.2022.2021.0675
AMA Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. . 2022; 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
Vancouver Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. . 2022; 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
IEEE Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L "Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation." , ss.103 - 108, 2022. 10.4274/tjh.galenos.2022.2021.0675
ISNAD Guven, Zeynep Tugba vd. "Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation". (2022), 103-108. https://doi.org/10.4274/tjh.galenos.2022.2021.0675
APA Guven Z, ÇELİK S, Eser B, ÇETİN M, ÜNAL A, Kaynar L (2022). Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. Turkish Journal of Hematology, 39(2), 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
Chicago Guven Zeynep Tugba,ÇELİK Serhat,Eser Bülent,ÇETİN Mustafa,ÜNAL Ali,Kaynar Leylagul Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. Turkish Journal of Hematology 39, no.2 (2022): 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
MLA Guven Zeynep Tugba,ÇELİK Serhat,Eser Bülent,ÇETİN Mustafa,ÜNAL Ali,Kaynar Leylagul Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. Turkish Journal of Hematology, vol.39, no.2, 2022, ss.103 - 108. 10.4274/tjh.galenos.2022.2021.0675
AMA Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. Turkish Journal of Hematology. 2022; 39(2): 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
Vancouver Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation. Turkish Journal of Hematology. 2022; 39(2): 103 - 108. 10.4274/tjh.galenos.2022.2021.0675
IEEE Guven Z,ÇELİK S,Eser B,ÇETİN M,ÜNAL A,Kaynar L "Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation." Turkish Journal of Hematology, 39, ss.103 - 108, 2022. 10.4274/tjh.galenos.2022.2021.0675
ISNAD Guven, Zeynep Tugba vd. "Eltrombopag for Treatment of Thrombocytopenia Following Hematopoietic Stem Cell Transplantation". Turkish Journal of Hematology 39/2 (2022), 103-108. https://doi.org/10.4274/tjh.galenos.2022.2021.0675