PB0338 - Efficacy comparison and safety analysis of megadose recombinant human thrombopoietin(rhTPO) in the treatment of immune thrombocytopenia (ITP)

Background: The conventional rhTPO dose was 300 U/Kg ,the clinical response rate was not satisfactory.So we explored the efficacy and safety of increasing dose.

Aims: To compare the efficacy and safety of recombinant human thrombopoietin (rhTPO) 15 000U and 30 000U in ITP.

Methods: ITP admitted to hematology Department of the Second Affiliated Hospital of Kunming Medical University from 2016 to 2021 were collected in A retrospective study. The patients were divided into group A (15 000U) and Group B (30 000U). The efficacy of the two groups were compared.

Results: The dose of rhTPO in group A and group B was (19830 ± 3427) U/Kg vs (19652 ± 2837) U/Kg according to the traditional dose. The total effective rate of group B vs group A(91.80% vs 70.45%,p < 0.01). On Day 7,Day 14,Day 21,and Day 28 of treatment, group B had better results(p < 0.001, p< 0.01, p>0.05, p>0.05). In fact, in our study, group B increased the dose of rhTPO and the efficacy was significantly improved.Group B demonstrated shorter onset of action, longer maintenance of efficacy, and better salvage therapy for relapsed patients（Table I）.Monotherapy were not different between the two groups, but high-dose rhTPO combined with hormone therapy were statistically significant(p < 0.01). There were no significant difference in the onset time of single drug therapy and combined glucocorticoid therapy. But, In group A, the onset time of monotherapy was faster than that of combined hormone therapy(p < 0.05), which may be due to the small number of cases（TableⅡ）.Platelet counts increased significantly in both groups after treatment. Treatment-related adverse events were reported in 6 (9.8%) and 6 (13.6%) patients in the group A and group B, respectively, all being mild and transient in nature .

Conclusion(s): Increasing the dose of rhTPO were effective and safe in the treatment of immune thrombocytopenia.Combination with glucocorticoids may be more effective.