Objective: To compare the short-term therapeutic effect of different regimens combining recombinant human thrombopoietin (rhTPO) with immunosuppressive therapy (IST) applied in severe aplastic anemia (SAA).
Methods: The clinical data of newly diagnosed adult SAA patients treated with first-line IST, including 18 patients with rhTPO daily and 43 patients with rhTPO every other day, was analyzed retrospectively.
Results: There was no significant difference between the basic clinical characteristics of the patients classified in different groups. The therapeutic effect was assessed 3 months and 6 months after IST. The statistical data revealed that the overall responses (OR) were not significantly different in daily group and every other day group (3 months: 50.0% vs 51.2%, P=0.934; 6 months: 77.8% vs 69.8%, P=0.525), while the good hematological response (CR+GPR) in SAA treated with rhTPO daily was significantly higher than that of patients treated with rhTPO every other day at 3 month after IST (38.9% vs 9.3%,P=0.011). RBC transfusion independence were not significantly different between the two groups after 4 weeks as well as 8 weeks treatment(4 weeks: 22.2% vs 18.6%,P=0.736; 8 weeks: 55.6% vs 46.5%,P=0.519), while platelet transfusion independence in rhTPO daily treated group was significantly higher than that in every other day group (88.9% vs 48.8%,P=0.003). In addition, there were no more adverse events observed in rhTPO daily group.
Conclusions: It's more effective to promote hematopoietic recovery and reduce platelet transfusion dependence when rhTPO was daily used other than used every other day.
目的: 比较不同重组人TPO（rhTPO）方案联合免疫抑制剂治疗重型再生障碍性贫血（SAA）的近期疗效。
方法: 回顾性分析接受一线免疫抑制治疗（IST）的61例成人SAA初诊患者资料，对比分析18例IST联合rhTPO每日1次（连续组）与43例IST联合rhTPO隔日1次（间日组）患者的疗效差异。
结果: 两组患者在IST前基础临床特征差异无统计学意义。IST后3个月和6个月进行疗效评估，连续组与间日组患者总体血液学反应率比较差异无统计学意义（3个月：50.0%对51.2%，P= 0.934；6个月：77.8%对69.8%，P=0.525）。连续组IST后3个月良好血液学反应率明显高于间日组（38.9%对9.3%，P=0.011）。rhTPO应用后4周和8周两组脱离红细胞输注率差异无统计学意义（4周：22.2%对18.6%，P=0.736; 8周：55.6%对46.5%，P=0.519），而治疗后8周脱离血小板输注率连续组明显高于间日组（88.9%对48.8%，P=0.003）。每日连续应用rhTPO治疗并不增加不良反应事件的发生。
结论: 每日1次较隔日1次应用rhTPO促进SAA造血恢复和减少血小板输注依赖更为有效。