Rescue treatment with eltrombopag in refractory cytopenias after allogeneic stem cell transplantation

Therapeutic Advances in Hematology
Semra AydinAlessandro Busca

Abstract

Patients with post-transplant cytopenias due to poor graft function or primary engraftment failure show poor prognosis with a high mortality rate mainly because of graft versus host disease (GVHD), infection and/or bleeding. Treatment options are scarce and a CD34+ stem cell boost or a second bone marrow transplantation may be required to restore adequate haematopoiesis. In the present study patients with primary engraftment failure (n = 1) and refractory poor graft function (n = 11) were treated with eltrombopag in a single centre. The reason for eltrombopag treatment was trilineage cytopenia in six patients, bilineage cytopenia in three patients and single lineage cytopenia in three patients. Eltrombopag was initiated at a median of 214 (range: 120-877) days after haematopoietic stem cell transplantation (HCST) and administered for a median time of 114 (range: 12 days to >490) days. In 8/12 patients eltrombopag was introduced at a dose of 75 mg/day and then increased to 150 mg/day after 1 week; 1 patient was given 50 mg eltrombopag per day, and 3 patients received 75 mg daily. In 10/12 patients eltrombopag significantly enhanced blood count values and patients became transfusion independent. Once stable haematological respons...Continue Reading

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Methods Mentioned

BETA
biopsy

Clinical Trials Mentioned

NCT01791101
NCT01000051
NCT01927731

Software Mentioned

GraphPad Prism

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