Recombinant human thrombopoietin for chronic liver disease-associated thrombocytopenia with or without concomitant infections: a real-world retrospective study.

Objectives: Recombinant human thrombopoietin (rhTPO) has been shown to improve platelet (PLT) counts in chronic liver disease (CLD)-associated thrombocytopenia (TP). However, whether concomitant infections influence its efficacy remains unclear. Methods: We conducted a retrospective study of 259 patients with CLD-associated TP who received rhTPO at Henan Provincial People's Hospital from January 2021 to October 2023. Patients were divided into concomitant infection (n = 178) and non-concomitant infection (n = 81) groups. Primary endpoints were the response rate and time to response. Secondary endpoints included the platelet transfusion requirements, PLT recovery differences and factors influencing rhTPO efficacy. Propensity score matching (PSM) was applied to adjust for baseline confounders. Results: After 1:1 PSM (n = 132), the overall response rate was 57.6% and the median time to response was 10 days, with no serious adverse events observed. Response rates and response time were comparable between concomitant infection and non-concomitant infection groups (59.1% vs. 56.1%, Conclusion: rhTPO was associated with improved PLT counts in CLD-associated TP without serious adverse events. This efficacy appeared comparable regardless of concomitant infection status. Liver function reserve may be the major determinant of efficacy. Prospective multicenter studies are needed to confirm these findings.