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BACKGROUND: Allogeneic hematopoietic stem cell transplantation is an important treatment for malignant hematological diseases, and delayed postoperative platelet implantation is a common complication that seriously affects the quality of patient survival; however, there are no standard protocols to improve platelet implantation rates and prevent platelet implantation delays. OBJECTIVE: To compare the safety and efficacy of oral Herombopag Olamine versus subcutaneous recombinant human thrombopoietin for promoting platelet implantation in patients with malignant hematological diseases undergoing haploid hematopoietic stem cell transplantation. METHODS: Clinical data of 163 patients with malignant hematological diseases who underwent haploidentical hematopoietic stem cell transplantation from January 2016 to October 2022 were retrospectively analyzed. A total of 72 patients who started to subcutaneously inject recombinant human thrombopoietin at +2 days were categorized into the recombinant human thrombopoietin group; a total of 27 patients who started to orally take Herombopag Olamine at +2 days were categorized into the Herombopag Olamine group; and 64 patients who did not apply Herombopag Olamine or recombinant human thrombopoietin were categorized into the blank control group. The implantation status, incidence of acute graft-versus-host disease of degree II-IV within 100 days, 1-year survival rate, 1-year recurrence rate, and safety were analyzed in the three groups. RESULTS AND CONCLUSION: (1) The average follow-up time was 52(12-87) months. The implantation time of neutrophils in the blank control group, recombinant human thrombopoietin group, and Herombopag Olamine group was (12.95±3.88) days, (14.04±3.71) days, and (13.89±2.74) days, respectively, with no statistically significant difference (P=0.352); the implantation time of platelets was (15.16±6.27) days, (17.67±6.52) days, and (17.00±4.75) days, with no statistically significant difference (P=0.287). (2) The complete platelet implantation rate on day 60 was 64.06%, 90.28%, and 92.59%, respectively, and the difference was statistically significant (P < 0.001). The subgroup analysis showed that the difference between the blank control group and the recombinant human thrombopoietin group was statistically significant (P < 0.001), and the difference between the blank control group and the Herombopag Olamine group was statistically significant (P=0.004). The difference was not statistically significant between the recombinant human thrombopoietin group and Herombopag Olamine group (P=0.535). (3) 100-day II-IV degree acute graft-versus-host disease incidence in the blank control group, recombinant human thrombopoietin group, and Herombopag Olamine group were 25.00%, 30.56%, and 25.93%, respectively, and the difference was not statistically significant (P=0.752). (4) The incidence of cytomegalovirus anemia, cytomegalovirus pneumonia, and hepatic function injury had no statistical difference among the three groups (P > 0.05). (5) During the follow-up period, there was no thrombotic event in any of the three groups of patients. (6) The results showed that recombinant human thrombopoietin and Herombopag Olamine could improve the platelet implantation rate of malignant hematological disease patients after haploidentical hematopoietic stem cell transplantation, with comparable efficacy and good safety [ABSTRACT FROM AUTHOR]

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BACKGROUND: In recent years, the application of new drugs such as monoclonal antibodies, small molecule targeted drugs and immunotherapy has significantly improved the short-term efficacy and long-term survival of patients with malignant lymphoma, but autologous hematopoietic stem cell transplantation still plays an important role in the overall treatment of malignant lymphoma. Preconditioning is a very important step in the whole process of autologous hematopoietic stem cell transplantation, but there is no standard preconditioning program at present. OBJECTIVE: To investigate the safety and effectiveness of Bendamustine, Etoposide, Cytarabine (Melphalan) BeEAM as preconditioning in autologous hematopoietic cell transplantation for patients with lymphomas. METHODS: From July 5, 2021 to May 31, 2022, 11 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation with BeEAM preconditioning regimen in Department of Hematology of Henan Provincial People’s Hospital were enrolled in the study. The clinical characteristics, pretreatingrelated non-hematologic toxicity, and hematopoietic reconstitution of the patients were analyzed. RESULTS AND CONCLUSION: (1) The non-hematological toxicity of BeEAM pretreatment regimen mainly included oral mucositis, diarrhea and fever at granulosa stage, with the incidence of 72.7%, 63.6%, 90.9%, respectively. (2) The median time of neutrophil implantation was 9(8-11) days, and that of platelet implantation was 10(7-16) days. (3) BeEAM pretreatment regimen for autologous hematopoietic stem cell transplantation of lymphoma has controllable nonhematologic toxicity and rapid hematopoietic reconstruction, with transplant-related mortality of 0% at 100 days and transplant-related mortality of 0% at the end of follow-up period, showing good efficacy and safety. Chinese Clinical Trial Registry: identifier No. ChiCTR2100048295. [ABSTRACT FROM AUTHOR]

BACKGROUND: The regimen of cyclosporin combined with four times of short-range methotrexate is still recognized as the classic prevention regimen for acute graft-versus-host disease. Previous studies have shown that whether day 11 methotrexate is used in sibling transplantation has no effect on the incidence of acute graft-versus-host disease. However, the effect of reducing day 11 methotrexate on the incidence of acute graft-versus-host disease in haploid hematopoietic stem cell transplantation patients remains unclear. OBJECTIVE: To investigate the efficacy of the omission of day 11 methotrexate in the regimen for the prophylaxis of graft-versus-host disease in haploid hematopoietic stem cell transplantation. METHODS: The clinical data of 63 patients with malignant hematologic diseases who received haploid hematopoietic stem cell transplantation from January 2017 to December 2019 were retrospectively analyzed. The graft-versus-host disease prevention regimen was cyclosporine combined with methotrexate 15 mg/m² on day 1, 10 mg/m² on day 3, day 6 and day 11. In the observation group (n=19), oral mucositis was grade III-IV at day 11, and day 11 methotrexate was cancelled. In the control group (n=44), oral mucositis was grade 0-II at day 11, and day 11 methotrexate was applied. The implantation situation, incidence of acute graft-versus-host disease, overall survival rate, and recurrence rate of the two groups were analyzed. RESULTS AND CONCLUSION: (1) The median follow-up time was 30(3-54) months and all neutrophils were successfully implanted in both groups. The median implantation time was 12(9-29) days and 12(8-25) days, respectively, showing no significant difference (P=0.682). There was one patient with poor platelet implantation in the observation group, and four patients with poor platelet implantation in the control group. The median time of platelet implantation was 12(9-18) days and 13(9-31) days in the two groups, respectively, (P=0.71), showing no statistical difference. (2) The overall incidence of acute graft-versus-host disease was 44.4%, and grade II-IV acute graft-versus-host disease was 28.6%. The incidence of II-IV acute graft-versus-host disease in the observation group and control group was 31.5% and 27.3%, respectively, (P=0.728), and there was no statistical difference between the two groups. (3) The results showed that for haploid hematopoietic stem cell transplantation, the omission of day 11 methotrexate did not increase the incidence of acute graft-versus-host disease compared with the standard methotrexate regimen. [ABSTRACT FROM AUTHOR]