Efficacy and safety of thrombopoietin receptor agonists in the treatment of thrombocytopenia after hematopoietic stem cell transplantation: a meta-analysis and systematic review. Issue 11 (2nd November 2021)

• Record Type: Journal Article
• Authors: Yao, Yifang; Tang, Yaqiong; Qi, JiaQian; Li, Xueqian; Zhang, Rui; Xu, Xiaoyan; Pan, Tingting; Han, Yue
• Is Part Of: Expert review of hematology. Volume 14:Issue 11(2021)
• Page Start: 1041
• Page End: 1048
• Publication Date: 2021-11-02
• Subjects: Thrombocytopenia -- Hematopoietic stem cell transplantation -- Thrombopoietin receptor agonists (TPO-RAs) -- Eltrombopag -- Romiplostim; Hematology -- Periodicals; 616.15005
• DOI: 10.1080/17474086.2021.2009337
• Languages: English
• ISSNs: 1747-4086

Abstract

ABSTRACT: Thrombocytopenia is a tough complication after hematopoietic stem cell transplantation (HSCT) with elusive pathogenesis and lack of well-established therapies. Thrombopoietin receptor agonists (TPO-RAs) have been used for thrombocytopenia post HSCT in recent years, but the outcomes remain debatable. We conducted this meta-analysis and systematic-review to evaluate the efficacy and safety of TPO-RAs for platelet recovery after HSCT. We searched PubMed, EMBASE, and Cochrane databases for studies on the application of TPO-RAs (eltrombopag and romiplostim) in the settings of primary or secondary thrombocytopenia after HSCT by 17 March 2021. Efficacy outcomes included response rate and survival rate, and adverse events were also evaluated. A total of 19 studies involving 378 patients were included. The pooled response rate was 73% (95%CI: 68–78%), which was significantly higher than recombinant human thrombopoietin (rhTPO) (27.8%). The pooled survival rate was 66% (95%CI: 54–77%), and infection was found to be the main cause of death. In addition, the pooled rate of adverse events was 3% (95%CI: 1–7%), with no severe adverse events reported. TPO-RAs could effectively and safely promote the recovery of platelets in patients after HSCT.