OC 33.3 - Efficacy and safety of avatrombopag in the treatment of thrombocytopenia after umbilical cord blood transplantation

Monday, June 24, 2024

10:00 – 10:15 ICT

Room: Ballroom B3

Presenting Author(s)

Aijie Huang, MD

Doctor
Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China
Hefei, Anhui, China (People's Republic)

Co-Author(s)

GS

Guangyu Sun

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
BT

Baolin Tang

Doctor
Anhui Provincial Hospital, Anhui, P.R. China
Hefei, Anhui, China (People's Republic)
YH

Yongsheng Han

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
XW

Xiang Wan

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
WY

Wen Yao

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
KS

Kaidi Song

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
YC

Yaxin Cheng

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
WW

Weiwei Wu

Professor
School of Public Health, Shanxi Medical University
Taiyuan, Shanxi, China (People's Republic)
MT

Meijuan Tu

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
YW

Yue Wu

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
TP

Tianzhong Pan

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)
XZ

Xiaoyu Zhu

Doctor
Department of Hematology, The First Affiliated Hospital of USTC
Hefei, Anhui, China (People's Republic)

Background: Delayed platelet engraftment is a common complication after umbilical cord blood transplantation (UCBT), and there is no standard therapy. Avatrombopag is a second-generation thrombopoietin receptor agonist (TPO-RA) that has shown efficacy in immune thrombocytopenia (ITP). However, few reports have focused on its efficacy in patients diagnosed with thrombocytopenia after UCBT.

Aims: To evaluate the safety and efficacy of avatrombopag post-UCBT.

Methods: We conducted a retrospective study to evaluate the efficacy of avatrombopag as a first-line TPO-RA in 65 patients post-UCBT; these patients were compared with 118 historical controls.

Results: Fifty-two patients were given avatrombopag within 30 days post-UCBT, and the treatment was continued for more than 7 days to promote platelet engraftment (avatrombopag group); the other 13 patients were given avatrombopag for secondary failure of platelet recovery (SFPR group). The median time to platelet engraftment was shorter in the avatrombopag group than in the control group (32.5 vs. 38 days, P = 0.036). Among the 52 patients in the avatrombopag group, 46 achieved an overall response (OR), and the cumulative incidence of OR was 91.9%. Thirty-nine of the 52 patients achieved complete remission (CR), and the cumulative incidence of CR was 89.2% (95% CI, 74.4%-95.7%). Patients treated with avatrombopag only had a greater 60-day cumulative incidence (CI) of platelet engraftment than patients treated with rhTPO only or rhTPO combined with avatrombopag (95.2% vs. 84.5% vs. 80.1%, P < 0.05, Figure 1). Patients suffering from SFPR had a slightly better CI of OR [100%, P = 0.104]. Patients who initiated avatrombopag treatment within 14 days post-UCBT had a better 60-day CI of platelet engraftment than did those who received avatrombopag after 14 days post-UCBT (96.6% vs. 73.9%, P = 0.003).

Conclusion(s): Our results indicate that avatrombopag could effectively promote platelet engraftment and recovery after UCBT, especially when used in the early period (≤14 days post-UCBT).