Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study

Background: Chemotherapy plus granulocyte colony-stimulating factor (GCSF) regimen is one of the available approaches to mobilize peripheral blood progenitor cells (PBPCs). It causes thrombocytopenia and delays leukapheresis. This study aimed to evaluate the role of recombinant human thrombopoietin...

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Autores principales:	Hongnan Mo, Peng Liu, Yan Qin, Xiaohui He, Xiaohong Han, Jiarui Yao, Weicai Su, Shuxiang Zhang, Le Tang, Fengyi Zhao, Lin Gui, Sheng Yang, Jianliang Yang, Shengyu Zhou, Zhishang Zhang, Yuankai Shi
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2021
Materias:	Recombinant human thrombopoietin Mobilization Lymphoma Schedule Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/279bea36891a4254ab4faafb9cb97354
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spelling	oai:doaj.org-article:279bea36891a4254ab4faafb9cb973542021-12-02T18:51:56ZRecombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study2095-882X10.1016/j.cdtm.2021.05.003https://doaj.org/article/279bea36891a4254ab4faafb9cb973542021-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X21000438https://doaj.org/toc/2095-882XBackground: Chemotherapy plus granulocyte colony-stimulating factor (GCSF) regimen is one of the available approaches to mobilize peripheral blood progenitor cells (PBPCs). It causes thrombocytopenia and delays leukapheresis. This study aimed to evaluate the role of recombinant human thrombopoietin (rhTPO) before mobilization chemotherapy in facilitating leukapheresis in patients with lymphoma. Methods: In this randomized open-label phase 2 trial, patients were randomly assigned in a 1:2 ratio to receive mobilization with rhTPO plus GCSF in combination with chemotherapy (the rhTPO plus GCSF arm) or GCSF alone in combination with chemotherapy (the GCSF alone arm). The recovery of neutrophils and platelets and the amount of platelet transfusion were monitored. Results: Thirty patients were enrolled in this study between March 2016 and August 2018. Patients in the rhTPO plus GCSF arm (n = 10) had similar platelet nadir after mobilization chemotherapy (P=0.878) and similar amount of platelet transfusion (median 0 vs. 1 unit, P=0.735) when compared with the GCSF alone arm (n = 20). On the day of leukapheresis, the median platelet count was 86 × 109/L (range 18–219) among patients who received rhTPO and 73 × 109/L (range 42–197) among those who received GCSF alone (P=0.982). After the use of rhTPO, the incidence of platelet count <75 × 109/L on the day of leukapheresis did not decrease significantly (30.0% vs. 50.0%, P=0.297). Platelet recovery after PBPC transfusion was more rapid in the rhTPO plus GCSF arm (median 8.0 days [95% confidence interval 2.9–13.1] to platelets ≥50 × 109/L vs. 11.0 days [95% confidence interval 8.6–13.4], P=0.011). The estimated total cost of the mobilization and reconstitution phases per patient was similar between the two treatmtent groups (P=0.362 and P=0.067, respectively). Conclusions: Our findings indicate that there was no significant clinical benefit of rhTPO use in facilitating mobilization of progenitor cells, but it may promote platelet recovery in the reconstitution phase after high-dose therapy. Trial registration: This trial has been registered in Clinicaltrials.gov as NCT03014102.Hongnan MoPeng LiuYan QinXiaohui HeXiaohong HanJiarui YaoWeicai SuShuxiang ZhangLe TangFengyi ZhaoLin GuiSheng YangJianliang YangShengyu ZhouZhishang ZhangYuankai ShiKeAi Communications Co., Ltd.articleRecombinant human thrombopoietinMobilizationLymphomaScheduleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 7, Iss 3, Pp 190-198 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Recombinant human thrombopoietin Mobilization Lymphoma Schedule Medicine (General) R5-920
spellingShingle	Recombinant human thrombopoietin Mobilization Lymphoma Schedule Medicine (General) R5-920 Hongnan Mo Peng Liu Yan Qin Xiaohui He Xiaohong Han Jiarui Yao Weicai Su Shuxiang Zhang Le Tang Fengyi Zhao Lin Gui Sheng Yang Jianliang Yang Shengyu Zhou Zhishang Zhang Yuankai Shi Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
description	Background: Chemotherapy plus granulocyte colony-stimulating factor (GCSF) regimen is one of the available approaches to mobilize peripheral blood progenitor cells (PBPCs). It causes thrombocytopenia and delays leukapheresis. This study aimed to evaluate the role of recombinant human thrombopoietin (rhTPO) before mobilization chemotherapy in facilitating leukapheresis in patients with lymphoma. Methods: In this randomized open-label phase 2 trial, patients were randomly assigned in a 1:2 ratio to receive mobilization with rhTPO plus GCSF in combination with chemotherapy (the rhTPO plus GCSF arm) or GCSF alone in combination with chemotherapy (the GCSF alone arm). The recovery of neutrophils and platelets and the amount of platelet transfusion were monitored. Results: Thirty patients were enrolled in this study between March 2016 and August 2018. Patients in the rhTPO plus GCSF arm (n = 10) had similar platelet nadir after mobilization chemotherapy (P=0.878) and similar amount of platelet transfusion (median 0 vs. 1 unit, P=0.735) when compared with the GCSF alone arm (n = 20). On the day of leukapheresis, the median platelet count was 86 × 109/L (range 18–219) among patients who received rhTPO and 73 × 109/L (range 42–197) among those who received GCSF alone (P=0.982). After the use of rhTPO, the incidence of platelet count <75 × 109/L on the day of leukapheresis did not decrease significantly (30.0% vs. 50.0%, P=0.297). Platelet recovery after PBPC transfusion was more rapid in the rhTPO plus GCSF arm (median 8.0 days [95% confidence interval 2.9–13.1] to platelets ≥50 × 109/L vs. 11.0 days [95% confidence interval 8.6–13.4], P=0.011). The estimated total cost of the mobilization and reconstitution phases per patient was similar between the two treatmtent groups (P=0.362 and P=0.067, respectively). Conclusions: Our findings indicate that there was no significant clinical benefit of rhTPO use in facilitating mobilization of progenitor cells, but it may promote platelet recovery in the reconstitution phase after high-dose therapy. Trial registration: This trial has been registered in Clinicaltrials.gov as NCT03014102.
format	article
author	Hongnan Mo Peng Liu Yan Qin Xiaohui He Xiaohong Han Jiarui Yao Weicai Su Shuxiang Zhang Le Tang Fengyi Zhao Lin Gui Sheng Yang Jianliang Yang Shengyu Zhou Zhishang Zhang Yuankai Shi
author_facet	Hongnan Mo Peng Liu Yan Qin Xiaohui He Xiaohong Han Jiarui Yao Weicai Su Shuxiang Zhang Le Tang Fengyi Zhao Lin Gui Sheng Yang Jianliang Yang Shengyu Zhou Zhishang Zhang Yuankai Shi
author_sort	Hongnan Mo
title	Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
title_short	Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
title_full	Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
title_fullStr	Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
title_full_unstemmed	Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study
title_sort	recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: results of a prospective randomized study
publisher	KeAi Communications Co., Ltd.
publishDate	2021
url	https://doaj.org/article/279bea36891a4254ab4faafb9cb97354
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Recombinant human thrombopoietin prior to mobilization chemotherapy facilitates platelet recovery in autologous transplantation in patients with lymphoma: Results of a prospective randomized study

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