Recombinant human thrombopoietin in pediatric allogeneic hematopoietic stem cell transplantation: Clinical insights and future directions

Abstract

The cohort study by Li et al provides timely and clinically relevant evidence on the use of recombinant human thrombopoietin (rhTPO) in pediatric allogeneic hematopoietic stem cell transplantation. The authors report enhanced platelet engraftment and a favorable safety profile, particularly in younger children aged 0-9 years. This age-dependent difference not only highlights the physiological responsiveness of early hematopoietic environments to rhTPO but also raises important questions about tailoring supportive therapies across pediatric age groups. While the findings are promising, the lack of a control group and single-center limitations warrant further multicenter, long-term investigations. Nevertheless, the study lays a compelling foundation for integrating rhTPO more broadly into pediatric transplant protocols and for advancing individualized post-transplant care.

Keywords: Recombinant human thrombopoietin; Pediatric hematopoietic stem cell transplantation; Platelet engraftment; Age-dependent response; Allogeneic transplantation; Supportive care

Core Tip: This cohort study evaluates the safety and efficacy of recombinant human thrombopoietin (rhTPO) in pediatric allogeneic hematopoietic stem cell transplantation. The findings suggest that rhTPO promotes earlier platelet engraftment, particularly in younger children aged 0-9 years. This age-dependent response highlights the influence of developmental hematopoiesis on treatment outcomes. Despite the limitations of a single-center, non-randomized design, the study provides novel insights that support rhTPO as a promising supportive therapy in pediatric allogeneic hematopoietic stem cell transplantation and underscores the need for age-specific post-transplant strategies.