Recombinant human thrombopoietin does not promote platelet engraftment in newly diagnosed multiple myeloma patients following autologous stem cell transplantation

To evaluate the effect of recombinant human thrombopoietin (rhTPO) on platelet engraftment after autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma (NDMM) patients. Clinical data of 40 NDMM patients who underwent high-dose melphalan conditioning and ASCT were analyzed, with 26 receiving rhTPO and 14 in the control group. The primary study endpoint was the median time to platelet engraftment. The secondary study endpoints included the median time to neutrophil engraftment, number of blood cells transfused, treatment-related adverse events, long-term hematopoietic reconstitution, and economic cost-effectiveness. The median time to neutrophil engraftment was 10.92 and 11.14 days in the rhTPO and control groups, respectively (p = 0.405). The median time to platelet engraftment (11.5 vs. 11.36 days, p = 0.776), median number of erythrocyte infusions (0.23 vs. 0 units, p = 0.326), and median number of platelet infusions (1.615 vs. 1.5 units, p = 0.721) did not significantly differ between the groups. The median hospitalization duration was 27.08 and 25.07 days in the rhTPO and control groups, respectively (p = 0.193). The median hospitalization cost was RMB 73,846 and RMB 54,136 in the rhTPO and control groups, respectively (p < 0.001). At 180 days post-transplantation, the neutrophil count, hemoglobin level, and platelet count did not significantly differ between the groups. Administering rhTPO after ASCT for NDMM did not accelerate platelet engraftment or reduce platelet transfusions, but increased hospitalization costs.