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Open-label pilot study of romiplostim for thrombocytopenia after autologous hematopoietic cell transplantation.

ABSTRACT: There are no standard treatments to prevent or hasten the recovery from severe conditioning-regimen-induced thrombocytopenia occurring after autologous hematopoietic cell transplantation (auto-HCT). We conducted an open-label, single-arm pilot study of romiplostim, a thrombopoietin receptor agonist, to enhance platelet recovery in patients with multiple myeloma or lymphoma undergoing auto-HCT. All patients were treated weekly with romiplostim starting day +1 after auto-HCT until the platelet count was >50 × 109/L without transfusion. Compared with contemporary retrospective data from romiplostim-naïve patients (N = 853), romiplostim-treated patients (N = 59) had a similar median number of days of grade 4 thrombocytopenia or days requiring transfusions, time to platelet engraftment, and number of platelets transfusions during the auto-HCT. However, romiplostim-treated patients had enhanced platelet recovery to normal values beginning at approximately day +15. In matched cohort multivariable analyses, romiplostim treatment was associated with higher platelet counts by an average of 40 × 109/L (95% confidence interval (CI) (14, 67), P = .003) and 118 × 109/L (95% CI [84, 152], P<.001) at days +21 and +30, respectively, compared with those of no romiplostim. Only 1 adverse event was deemed possibly attributable to romiplostim: a low-risk pulmonary embolism in a patient with multiple myeloma. In conclusion, romiplostim showed promising activity and safety after auto-HCT, but the improvement in platelet counts occurred later than the goal of shortening the duration and depth of the platelet nadir. This trial was registered at www.clinicaltrials.gov (#NCT04478123).

SUBMITTER: Scordo M

PROVIDER: S-EPMC10130608 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Open-label pilot study of romiplostim for thrombocytopenia after autologous hematopoietic cell transplantation.

Scordo Michael M Gilbert Leah J LJ Hanley Danielle M DM Flynn Jessica R JR Devlin Sean M SM Nguyen Linh K LK Ruiz Josel D JD Shah Gunjan L GL Sauter Craig S CS Chung David J DJ Landau Heather J HJ Lahoud Oscar B OB Lin Richard J RJ Dahi Parastoo B PB Perales Miguel-Angel MA Giralt Sergio A SA Soff Gerald A GA

Blood advances 20230401 8

There are no standard treatments to prevent or hasten the recovery from severe conditioning-regimen-induced thrombocytopenia occurring after autologous hematopoietic cell transplantation (auto-HCT). We conducted an open-label, single-arm pilot study of romiplostim, a thrombopoietin receptor agonist, to enhance platelet recovery in patients with multiple myeloma or lymphoma undergoing auto-HCT. All patients were treated weekly with romiplostim starting day +1 after auto-HCT until the platelet cou ...[more]

PMID: 36409612

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Dataset Information

Open-label pilot study of romiplostim for thrombocytopenia after autologous hematopoietic cell transplantation.

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Open-label pilot study of romiplostim for thrombocytopenia after autologous hematopoietic cell transplantation.

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