Successful Treatment of Primary Poor Graft Function After Haploidentical Hematopoietic Stem Cell Transplantation With Low-Dose Decitabine Followed by Donor Lymphocyte Infusion and Eltrombopag

采用低剂量地西他滨联合供者淋巴细胞输注和艾曲波帕成功治疗单倍体造血干细胞移植后原发性移植物功能不良。

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Abstract

OBJECTIVE: Primary poor graft function (PGF) is a common and serious complication after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). This study retrospectively evaluates the efficacy and safety of a novel combination therapy consisting of low-dose decitabine, donor lymphocyte infusion (DLI), and eltrombopag for the treatment of primary PGF subsequent to haplo-HSCT. METHODS: In this analysis of ten patients, decitabine was administered at a dose of 7 mg/m(2)/day for three consecutive days, followed by DLI on the fifth day and eltrombopag, which was started at 50 mg/day and titrated up to 150 mg. The primary endpoints of the study encompassed hematologic recovery. RESULTS: Nine patients (90%) achieved a complete response with normalized blood counts, while one patient (10%) showed a partial response with transfusion independence. Adverse events included manageable graft-versus-host disease (GVHD) in four patients. CONCLUSION: These findings indicate that this triple therapy represents a promising approach for the management of primary PGF following haplo-HSCT.

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