Efficacy analysis of rhTPO and construction of recovery prediction model in acute myeloid leukemia patients with post-chemotherapy thrombocytopenia

Recombinant human thrombopoietin (rhTPO) is frequently utilized for platelet regeneration following chemotherapy in patients with acute myeloid leukemia (AML) in China. We studied rhTPO's effect and safety and created a nomogram model to predict AML patients' platelet recovery following chemotherapy by real-world clinical information. From January 2016 to May 2022, 347 AML patients with first-time induction chemotherapy at the First Affiliated Hospital of Anhui Medical University were divided into two groups based on rhTPO treatment. The two groups were compared for platelet count recovery, recovery speed, platelet transfusion volume, overall survival, progression-free survival and adverse events. A nomogram was constructed by screening significant influences using univariable and multivariate logistic regression analyses, and the model's discriminative ability, calibration, and clinical utility were examined. The experimental group had a higher level and speed of platelet recovery. The duration of thrombocytopenia (PLT < 20 × 109/L) and the time required for platelet count recovery to above 30, 50, 80, and 100 × 109/L were all shorter in the experimental group. In addition, there were no differences in platelet transfusion volume, chemotherapeutic remission rate, OS, PFS, or adverse events. Multivariate Logistics regression analysis found that rhTPO, Hb, MPV, initial platelet level, and ASXL1 mutation independently affected platelet recovery speed. A nomogram model was created from the above elements. AUC for the training and validation groups was 0.789 (95%CI: 0.723–0.846) and 0.759 (95%CI: 0.67–0.848). In conclusion, rhTPO exhibits favorable efficacy and safety profiles in facilitating platelet recovery following chemotherapy in AML patients. A nomogram prediction model based on the aforementioned influencing factors can be established to predict platelet recovery.