Recombinant Human Thrombopoietin in the Treatment of Chemotherapy-Induced Thrombocytopenia in Acute Myeloid Leukemia

Objective: To investigate the efficacy and safety of recombinant human thrombopoietin(rhTPO) in the treatment of thrombocytopenia after chemotherapy for acute myeloid leukemia in vivo and in vitro.

Methods: A retrospective collection of 95 patients with acute myeloid leukemia who suffered thrombocytopenia after chemotherapy in Zhongnan hospital from July 2014 to April 2019 were collected. The patients were divided into two groups according to different medications, one group was treated with reorganized human thrombopoietin, the other one with recombinant IL-11, the platelet counts between two groups was analyzed and the platelet recovery under different ages, medical conditions and other factors were analyzed; mice patient derived xenograft model of acute myeloid leukemia with thrombocytopenia after chemotherapy was established to verify the efficacy and the mechanism of rhTPO.

Results: Since the platelet counts began to recover, the platelet increase in rhTPO group was significantly greater than that in IL-11 group, the platelet count is significantly higher than IL-11 group at Day42 (P<0.05). Age and whether it is chemotherapy-naive patient has no significant effect on the function of rhTPO in restoring platelet counts. It is verified that rhTPO can increase platelet counts, but has no significant effect on leukocytes, erythrocytes. The injection of rhTPO leads to more synthesis of TPO in liver by activating the JAK2-STAT3 pathway.

Conclusion: Our work has paved the way for further study on the clinical application of rhTPO in managing thrombocytopenia for AML after chemotherapy.