Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data
Background: Eltrombopag has an off-label indication for haematopoietic cell transplantation in patients experiencing delayed thrombocyte recovery and/or thrombocytopaenia. Aims: To present our centre’s experience of using this agent not only for post- haematopoietic cell transplantation thrombocyto...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-01-01
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| Series: | Balkan Medical Journal |
| Online Access: | http://www.balkanmedicaljournal.org/text.php?lang=en&id=2460 |
| _version_ | 1797921832192442368 |
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| author | Ekin Kırcalı Güldane Cengiz Seval Cemaleddin Öztürk Hülya Yılmaz Derya Koyun Sinem Civriz Bozdağ Selami Koçak Toprak Pervin Topçuoğlu Önder Arslan Muhit Özcan Taner Demirer Osman İlhan Günhan Gürman Meral Beksaç Meltem Kurt Yüksel |
| author_facet | Ekin Kırcalı Güldane Cengiz Seval Cemaleddin Öztürk Hülya Yılmaz Derya Koyun Sinem Civriz Bozdağ Selami Koçak Toprak Pervin Topçuoğlu Önder Arslan Muhit Özcan Taner Demirer Osman İlhan Günhan Gürman Meral Beksaç Meltem Kurt Yüksel |
| author_sort | Ekin Kırcalı |
| collection | DOAJ |
| description | Background: Eltrombopag has an off-label indication for haematopoietic cell transplantation in patients experiencing delayed thrombocyte recovery and/or thrombocytopaenia.
Aims: To present our centre’s experience of using this agent not only for post- haematopoietic cell transplantation thrombocytopaenia but also for poor graft functioning in the post-haematopoietic cell transplantation setting.
Study Design: Retrospective cross-sectional study.
Methods: Thirty-nine patients who had persistent cytopaenia following haematopoietic cell transplantation and treated with eltrombopag at our centre between October 2011 and December 2021 were retrospectively identified. During this period, 9 (23.1%) and 30 (76.9%) patients who underwent allogeneic transplantations, respectively, received eltrombopag.
Results: The female-to-male ratio was 12:27, and the median transplant age was 49 (18-70) years. Eight (20.5%) patients had isolated thrombocytopaenia, 19 (49.4%) had bi-lineage cytopaenia and 12 (30.1%) had pancytopaenia. Patients received a median of 50 mg/day (25-150 mg/day) of eltrombopagfor a median duration of 82 (24-386) days. Nine (23.1%) patients had autologous haematopoietic cell transplantation, and 30 (76.9%) had allogeneic haematopoietic cell transplantation (14 unrelated, 9 sibling and 7 haploidentical). The median donor age was 32 (20-67) years. The median follow-up was 16.4 (1.8-84.3) months. The median pre-treatment platelet count was 11x109/l (1-23), which increased to 41x109/l (6-150). The median platelet count increment was 29.5x109/l (p = 0.001). The pre-treatment median neutrophil count was 1.19x109/l (0.39-5.1), which increased to 2.35 x109/l (0.1-5.33) (p = 0.05), and the pre-treatment median haemoglobin was 8.3 (6.2-14) g/dl, which increased to 10 (6.2-14) g/dl (p = 0.001) with eltrombopag. No eltrombopag-related hepatotoxicity occurred; however, 1 (2.6%) patient failed to continue treatment because of two consecutive episodes of deep venous thrombosis. Six (15.4%) patients were unresponsive to eltrombopag and dependent on blood product transfusions. After a median time of 82 days, 61.5% of the patients discontinued eltrombopag successfully.
Conclusion: The results confirmed that eltrombopag could provide a rapid, sustained response in patients with poor graft functioning after haematopoietic cell transplantation. This finding is essential given the high rate of non-relapse mortality caused by poor graft functioning after haematopoietic cell transplantation. |
| first_indexed | 2024-04-10T14:21:45Z |
| format | Article |
| id | doaj.art-5219a9df98b1474a902d24e5d219b1ab |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-04-10T14:21:45Z |
| publishDate | 2023-01-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-5219a9df98b1474a902d24e5d219b1ab2023-02-15T16:09:16ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312023-01-01401515610.4274/balkanmedj.galenos.2022.2022-2-48Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life DataEkin Kırcalı0https://orcid.org/0000-0003-3836-0434Güldane Cengiz Seval1https://orcid.org/0000-0001-9433-2054Cemaleddin Öztürk2https://orcid.org/0000-0003-1591-6575Hülya Yılmaz3https://orcid.org/0000-0001-5664-5893Derya Koyun4Sinem Civriz Bozdağ5https://orcid.org/0000-0001-8359-7794Selami Koçak Toprak6https://orcid.org/0000-0001-7717-5827Pervin Topçuoğlu7https://orcid.org/0000-0002-3956-5960Önder Arslan8https://orcid.org/0000-0002-1883-1414Muhit Özcan9https://orcid.org/0000-0002-1326-1918Taner Demirer10https://orcid.org/0000-0002-2214-5927Osman İlhan11https://orcid.org/0000-0003-1665-372XGünhan Gürman12https://orcid.org/0000-0002-1263-8947Meral Beksaç13https://orcid.org/0000-0003-1797-8657Meltem Kurt Yüksel14https://orcid.org/0000-0003-0369-299XDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyBackground: Eltrombopag has an off-label indication for haematopoietic cell transplantation in patients experiencing delayed thrombocyte recovery and/or thrombocytopaenia. Aims: To present our centre’s experience of using this agent not only for post- haematopoietic cell transplantation thrombocytopaenia but also for poor graft functioning in the post-haematopoietic cell transplantation setting. Study Design: Retrospective cross-sectional study. Methods: Thirty-nine patients who had persistent cytopaenia following haematopoietic cell transplantation and treated with eltrombopag at our centre between October 2011 and December 2021 were retrospectively identified. During this period, 9 (23.1%) and 30 (76.9%) patients who underwent allogeneic transplantations, respectively, received eltrombopag. Results: The female-to-male ratio was 12:27, and the median transplant age was 49 (18-70) years. Eight (20.5%) patients had isolated thrombocytopaenia, 19 (49.4%) had bi-lineage cytopaenia and 12 (30.1%) had pancytopaenia. Patients received a median of 50 mg/day (25-150 mg/day) of eltrombopagfor a median duration of 82 (24-386) days. Nine (23.1%) patients had autologous haematopoietic cell transplantation, and 30 (76.9%) had allogeneic haematopoietic cell transplantation (14 unrelated, 9 sibling and 7 haploidentical). The median donor age was 32 (20-67) years. The median follow-up was 16.4 (1.8-84.3) months. The median pre-treatment platelet count was 11x109/l (1-23), which increased to 41x109/l (6-150). The median platelet count increment was 29.5x109/l (p = 0.001). The pre-treatment median neutrophil count was 1.19x109/l (0.39-5.1), which increased to 2.35 x109/l (0.1-5.33) (p = 0.05), and the pre-treatment median haemoglobin was 8.3 (6.2-14) g/dl, which increased to 10 (6.2-14) g/dl (p = 0.001) with eltrombopag. No eltrombopag-related hepatotoxicity occurred; however, 1 (2.6%) patient failed to continue treatment because of two consecutive episodes of deep venous thrombosis. Six (15.4%) patients were unresponsive to eltrombopag and dependent on blood product transfusions. After a median time of 82 days, 61.5% of the patients discontinued eltrombopag successfully. Conclusion: The results confirmed that eltrombopag could provide a rapid, sustained response in patients with poor graft functioning after haematopoietic cell transplantation. This finding is essential given the high rate of non-relapse mortality caused by poor graft functioning after haematopoietic cell transplantation.http://www.balkanmedicaljournal.org/text.php?lang=en&id=2460 |
| spellingShingle | Ekin Kırcalı Güldane Cengiz Seval Cemaleddin Öztürk Hülya Yılmaz Derya Koyun Sinem Civriz Bozdağ Selami Koçak Toprak Pervin Topçuoğlu Önder Arslan Muhit Özcan Taner Demirer Osman İlhan Günhan Gürman Meral Beksaç Meltem Kurt Yüksel Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data Balkan Medical Journal |
| title | Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data |
| title_full | Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data |
| title_fullStr | Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data |
| title_full_unstemmed | Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data |
| title_short | Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data |
| title_sort | eltrombopag for the treatment of poor graft function following haematopoietic cell transplantation real life data |
| url | http://www.balkanmedicaljournal.org/text.php?lang=en&id=2460 |
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