Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2022; 14(11): 1260-1271
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1260
Recombinant human thrombopoietin treatment in patients with chronic liver disease-related thrombocytopenia undergoing invasive procedures: A retrospective study
Jing-Nuo Ding, Ting-Ting Feng, Wei Sun, Xin-Yi Cai, Yun Zhang, Wei-Feng Zhao
Jing-Nuo Ding, Ting-Ting Feng, Wei Sun, Xin-Yi Cai, Yun Zhang, Wei-Feng Zhao, Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: All the authors solely contributed to this paper. Ding JN, Feng TT and Zhao WF designed the research study; Ding JN, Feng TT, Sun W, Cai XY, Zhang Y and Zhao WF performed the research; Ding JN, Cai XY and Zhang Y analyzed the data and wrote the manuscript; Feng TT, Sun W and Zhao WF revised the manuscript; all authors have read and approve the final manuscript.
Supported by the Science and Technology Development Plan of Suzhou, Jiangsu Province, China, No. SYS2020009.
Institutional review board statement: The study was reviewed by the ethics committee of the First Affiliated Hospital of Soochow University, and ethical approval was obtained (2020 Ethics Approval No. 216).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wei-Feng Zhao, MD, Chief Physician, Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Gusu District, Suzhou 215000, Jiangsu Province, China.
Received: September 19, 2022
Peer-review started: September 19, 2022
First decision: October 21, 2022
Revised: October 30, 2022
Accepted: November 16, 2022
Article in press: November 16, 2022
Published online: November 27, 2022
Research background

Thrombocytopenia is a common complication in chronic liver disease (CLD), promoting a high risk of bleeding and a poor prognosis, especially in patients undergoing invasive procedures or surgeries.

Research motivation

Recombinant human thrombopoietin (rhTPO) is commonly used to treat primary immune thrombocytopenic purpura and thrombocytopenia caused by solid tumor chemotherapy, and has not been extensively investigated in the treatment of CLD-related thrombocytopenia.

Research objectives

This study aimed to evaluate the efficacy of rhTPO in the treatment of patients with CLD-associated thrombocytopenia undergoing invasive procedures.

Research methods

This retrospective analysis of clinical data of patients with CLD assessed the changes in platelet counts and parameters before and after the use of rhTPO for thrombocytopenia. Subgroup analysis was performed according to different characteristics, such as baseline platelet count levels. Adverse events related to treatment were investigated.

Research results

Among the enrolled patients, 78 (78%) showed an elevation in platelet count after rhTPO use. The mean platelet count after rhTPO treatment in all patients was 101.53 ± 81.81 × 109/L, which was significantly improved compared to that at baseline (42.88 ± 16.72 × 109/L), and this difference was statistically significant (P < 0.001). Subgroup analysis also showed the same result. Ninety (90%) patients did not require platelet transfusion partially due to an increase in platelet count after treatment with rhTPO.

Research conclusions

rhTPO was effective in the treatment of CLD-associated thrombocytopenia with good medication safety, promoting the safety of invasive procedures and improving overall survival of patients with CLD.

Research perspectives

rhTPO could be a new approach for the treatment of CLD-related thrombocytopenia that will promote clinical benefits in patients with CLD who are undergoing invasive procedures.