Abstract
Thrombocytopenia following allogeneic hematopoietic stem cell transplantation is a usual complication and can lead to high morbidity and mortality. New strategies, such as the use of another graft versus host-disease prophylaxis, alternative donors, and management of infections, have improved the survival of these patients. The mechanisms are unknown; therefore, the identification of new strategies to manage this potentially serious problem is needed. Thrombopoietin receptor agonists are currently available to stimulate platelet production. Some small retrospective studies have reported their potential efficacy in an allogeneic stem cell transplant setting, confirming good tolerability. Recent studies with higher numbers of patients also support their safety and efficacy in this setting, hence establishing the use of these drugs as a promising strategy for this post-transplant complication. However, prospective trials are needed to confirm these results.
Highlights
Thrombocytopenia following allogeneic hematopoietic stem cell transplantation is a usual complication and could often increase morbidity and mortality [1]
Zhang et al [10] demonstrated an increase in immature megakaryocytes in allo-SCT patients with Prolonged isolated thrombocytopenia (PT) with low ploidy, which was related to the recruitment of CD8 T-cells, suggesting the role of the bone marrow (BM) immune microenvironment
These results suggest that the presence of megakaryocytes in BM may better predict the response to these agents than the type of thrombocytopenia after transplant [28]
Summary
Thrombocytopenia following allogeneic hematopoietic stem cell transplantation (alloSCT) is a usual complication and could often increase morbidity and mortality [1]. Prolonged isolated thrombocytopenia (PT) has been described in 5–20% of cases [3] and is defined as persistent thrombocytopenia (
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