Photo Credit: Artur Plawgo
The following is a summary of “Eltrombopag improves platelet engraftment after haploidentical bone marrow transplantation: Results of a Phase II study,” published in the February 2024 issue of Hematology by Ahmed et al.
Slow platelet recovery is common post haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with bone marrow graft and post-transplant cyclophosphamide (PCy)-based graft-versus-host disease (GVHD) prophylaxis alleviated by enhanced recovery, decreasing transfusion necessity and improving outcomes.
Researchers performed a retrospective study to evaluate the efficacy of GVHD prophylaxis based on PCy following transplantation.
They conducted a study involving patients aged ≥18 who underwent haplo-HSCT with bone marrow graft and PCy. Patients were administered eltrombopag at 300 mg/day dose from Day +5. The primary aim was to assess platelet engraftment (>50 000/μL by Day 60). A post hoc analysis compared them to a contemporary matched control group without eltrombopag administration.
The results showed that among 110 patients (30 receiving eltrombopag and 80 controls), 73% and 50% of patients in the eltrombopag and control groups achieved a platelet count >50,000/μL by Day 60 (P=.043). There were no eltrombopag-related grade ≥4 adverse events observed. The median time to platelet recovery (>20,000/μL) was 29 days with eltrombopag compared to 31 days for controls (P=.022), with a cumulative incidence of 90% (95% CI: 78%–100%) for eltrombopag versus 67.5% (95% CI: 57%–78%) for controls (P=.014). The two groups were similar in the number of platelet transfusions received, OS, PFS, GVHD rate, relapse rate, and non-relapse mortality.
They concluded that Haplo-HSCT patients receiving bone marrow grafts and PCy benefit from eltrombopag with safe and effective improvement in platelet recovery.