Romiplostim N01 accelerates platelet engraftment in autologous stem cell transplantation using non-cryopreserved peripheral blood stem cells for plasma cell neoplasms

Delayed platelet engraftment remains a major limitation of autologous stem cell transplantation (ASCT) for plasma-cell neoplasms. Romiplostim N01, a thrombopoietin receptor agonist, may enhance early megakaryocytic recovery, while the use of non-cryopreserved peripheral blood stem cells (PBSCs) eliminates dimethyl-sulfoxide–related toxicity and reduces procedural cost. This retrospective study evaluated 15 patients receiving non-cryopreserved PBSCs and early Romiplostim N01 after ASCT and compared them with 21 historical controls who received cryopreserved PBSCs and recombinant human thrombopoietin. We tried to compare time to engraftment, transfusion burden, hospitalization duration and cost, safety, hematologic responses and survival outcomes. Platelet engraftment occurred significantly earlier in the Romiplostim N01 cohort (median 11 vs. 13 days; P  = 0.008), and complete platelet recovery by day + 30 was higher (100% vs. 66.7%; P  = 0.027). Neutrophil recovery, transfusion requirements, and hospitalization duration were comparable between groups. Total hospitalization cost was markedly lower with Romiplostim N01 (77,609 ± 21,624 vs. 106,188 ± 14,910 CNY; P  < 0.001). The two patient groups also demonstrated comparable safety profiles, treatment responses, and survival outcomes. Romiplostim N01 safely accelerates thrombopoietic recovery and substantially reduces cost when combined with non-cryopreserved PBSCs. This strategy represents a practical and economically favorable supportive-care model for ASCT.