Eltrombopag may induce bone marrow fibrosis in allogeneic hematopoietic stem cell transplant recipients with prolonged thrombocytopenia

BOSTANKOLU DEĞİRMENCİ B., YEGİN Z. A., DİKYAR A., AYDIN KAYNAR L., ÖZKURT Z. N., UYAR GÖÇÜN F. P., ...Daha Fazla

Leukemia Research, cilt.118, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 118
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.leukres.2022.106870
  • Dergi Adı: Leukemia Research
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: Thrombopoietin receptor agonists, Eltrombopag, Thrombocytopenia, Allogeneic hematopoietic stem cell, transplantation, Bone marrow fibrosis, Poor graft function, CONSENSUS
  • Gazi Üniversitesi Adresli: Evet

Özet

© 2022 Elsevier LtdPoor graft function (PGF) and secondary failure of platelet recovery (SFPR) are significant causes of transplant related morbidity and mortality. Although thrombopoietin receptor agonists (TPO-RA), particularly Eltrombopag (EPAG), have been reported to be efficacious in the treatment of prolonged thrombocytopenia, potential long term adverse effects remain to be elucidated. This retrospective study was performed to determine the efficacy and toxicity profile of TPO-RAs in allogeneic hematopoietic stem cell transplant (alloHCT) recipients. Medical records of 27 patients [median age: 55(21−73) years; male/female: 15/12] who received posttransplant EPAG for SFPR or PGF were analysed. Eltrombopag was started on day 110(33−670) after transplant. Median initial dose was 25(25−50) mg/day which was properly escalated to a maximum dose of 75(50−100) mg/day. Duration of the treatment was median 120(31−377) days. Overall response rate (ORR) was 59.3% in the study population. Time-to-treatment response was 42(3−170) days. Mild-to-moderate bone marrow fibrosis was detected in the posttreatment biopsies of 12/22 patients (54.5%), 9 of whom did not represent any grade of myelofibrosis in their inital biopsies. The grade of posttreatment fibrosis was significantly increased when time-to-treatment response was longer (p = 0.008). Long term use of TPO-RAs may be considered as a potential cause of myelofibrosis in alloHCT recipients.