Successful Treatment of Primary Poor Graft Function After Haploidentical Hematopoietic Stem Cell Transplantation With Low-Dose Decitabine Followed by Donor Lymphocyte Infusion and Eltrombopag.

OBJECTIVE

Primary poor graft function (PGF) is a common and serious complication after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). This study retrospectively evaluates the efficacy and safety of a novel combination therapy consisting of low-dose decitabine, donor lymphocyte infusion (DLI), and eltrombopag for the treatment of primary PGF subsequent to haplo-HSCT.

METHODS

In this analysis of ten patients, decitabine was administered at a dose of 7 mg/m2/day for three consecutive days, followed by DLI on the fifth day and eltrombopag, which was started at 50 mg/day and titrated up to 150 mg. The primary endpoints of the study encompassed hematologic recovery.

RESULTS

Nine patients (90%) achieved a complete response with normalized blood counts, while one patient (10%) showed a partial response with transfusion independence. Adverse events included manageable graft-versus-host disease (GVHD) in four patients.

CONCLUSION

These findings indicate that this triple therapy represents a promising approach for the management of primary PGF following haplo-HSCT.