| Literature DB >> 33646303 |
Yaqiong Tang1,2,3, Jia Chen1,2,3,4, Qifa Liu5, Tiantian Chu1,2,3, Tingting Pan1,2,3, Jianying Liang1,2,3, Xue Feng He1,2, Feng Chen1,2, Ting Yang6,7, Xiao Ma1,2, Xiaojin Wu1,2, Shaoyan Hu8, Xingyu Cao9, Xiaohui Hu1,2,3, Jiong Hu10, Yuejun Liu1,2, Jiaqian Qi1,2,3, Yueping Shen11, Changgeng Ruan1,2,3,4, Yue Han1,2,3,4, Depei Wu1,2,3,4.
Abstract
Refractory prolonged isolated thrombocytopenia (RPIT) is an intractable complication after allogeneic hematopoietic cell transplantation (HCT), which often leads to poor prognosis. A clinical study was designed to validate the efficacy and safety of low-dose decitabine for RPIT after HCT and explore the related underlying mechanisms. Eligible patients were randomly allocated to receive 1 of 3 interventions: arm A, low-dose decitabine (15 mg/m2 daily IV for 3 consecutive days [days 1-3]) plus recombinant human thrombopoietin (300 U/kg daily); arm B, decitabine alone; or arm C, conventional treatment. The primary end point was the response rate of platelet recovery at day 28 after treatment. Secondary end points included megakaryocyte count 28 days after treatment and survival during additional follow-up of 24 weeks. Among the 91 evaluable patients, response rates were 66.7%, 73.3%, and 19.4% for the 3 arms, respectively (P < .001). One-year survival rates in arms A (64.4% ± 9.1%) and B (73.4% ± 8.8%) were similar (P = .662), and both were superior to that in arm C (41.0% ± 9.8%; P = .025). Megakaryocytes, endothelial cells (ECs), and cytokines relating to megakaryocyte migration and EC damage were improved in patients responding to decitabine. This study showed low-dose decitabine improved platelet recovery as well as overall survival in RPIT patients after transplantation. This trial was registered at www.clinicaltrials.gov as #NCT02487563.Entities:
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Year: 2021 PMID： 33646303 PMCID： PMC7948276 DOI： 10.1182/bloodadvances.2020002790
Source DB: PubMed Journal: Blood Adv ISSN： 2473-9529