重组人血小板生成素对外周血造血干细胞移植后患者血小板重建的影响

目的观察外周血干细胞移植(PBHSCT)后d3使用重组人血小板生成素(rHuTPO)对移植后患者血小板重建的影响及其不良反应。方法根据PBHSCT后d3是否使用rHuTPO的情况,将2011年在本科接受PBHSCT的40名患者分为rHuTPO治疗组(n=20)和对照组(n=20),回顾性分析、比较2组中接受3种不同移植物来源(自体造血干细胞、HLA异基因相合造血干细胞和HLA单体型相合异基因造血干细胞)的患者移植后血小板重建、输注血小板次数等相关指标。结果 HLA自体造血干细胞移植病例中,rHuTPO治疗组(n=4)和对照组(n=6)患者移植后Plt升至20×109/L的时间分别为(19.33±4.03)d,(23.75±8.78)d,血小板输注次数中位数分别为5.5次、11.5次(P0.05)。HLA异基因全相合造血干细胞移植病例中,rHuTPO治疗组(n=8)和对照组(n=10)患者移植后Plt升至20×109/L的时间分别为(14.50±4.22)d,(16.13±6.58)d,血小板输注次数中位数分别为3.0次、4.0次(P0.05)。在HLA单体型相合造血干细胞移植病例中,rHuTPO治疗组(n=8)和对照组(n=4)患者移植后Plt升至20×109/L的时间分别为(16.50±7.14)d、(23.63±5.50)d(P0.05),Plt升至50×109/L的时间分别为(20.25±7.23)d、(31.75±5.23)d(P0.05),血小板输注次数中位数分别为3.0次、12.5次(P0.05)。结论 HLA异基因单体型相合相合造血干细胞移植后d3应用rHuTPO有助于移植患者血小板较快生成并减少血小板输注次数。

Recombinant human thrombopoietin in recovery of platelet after peripheral blood hematopoietic stem cell transplantation

objective To observe the effects of recombinant human thrombopoietin on recovery of thrombocytopenia after peripheral blood hematopoietic stem cell transplantation.Methods 40 patients who underwent hematopoietic stem cell transplantation(HSCT) in the department of hematology,Zhujiang hospital from Jan to dec 2011 were enrolled.In the rHuTPO treatment group(n=20),rHuTPO was administered to patients since 3 days post stem cell infusion till to the platelet counts more than 50×109/L,while in control group(n=20),no rHuTPO was administered.The platelet recovery times and the numbers of platelet transfusions between rHuTPO treatment group and the control group from three different kinds of stem cells were compared respectively.Results In patients of auto-HSCT,the average time of the platelet to recover to more than 20×109/L was(19.33±4.03)days in rHuTPO treatment group(n=4) and(23.75±8.78) days in control group(n=6),the median of platelet transfusions were 5.5 and 11.5,respectively,there were no different statistical significance(P>0.05).In patients of HLA matched allo-HSCT,the average time of the platelet to recover to more than 20×109/L was(14.50±4.22)days in rHuTPO treatment group(n=8) and(16.13±6.58)days in control group(n=10),the median of platelet transfusions were 3.0 and 4.0,respectively,there were no different statistical significance(P>0.05).In patients of HLA mismatched allo-HSCT,There was no obvious statistical significance on the average time of the platelet to recover to more than 20×109 /L,which was(16.50±7.14)days in rHuTPO treatment group(n=8) and(23.63±5.50)days in control group(n=4).(P>0.05).And the average time of the platelet to recover to more than 50×109/L was(20.25±7.23) days in rHuTPO treatment group and(31.75±5.23)days in control group(P=0.02).In rHuTPO treatment group,the median of platelet transfusions for the patients and those without were 3.0 and 12.5,respectively(P=0.01),there were statistical significance.Conclusion In HLA mismatched allo-HSCT group,the rHuTPO used to patients since 3 days post stem cell infusion helps to promote recovery of platelet and increase numbers of platelet transfusions.