This is a multicenter, prospective, single-arm, phase II clinical study evaluating the early prophylactic use of recombinant human thrombopoietin (rhTPO) to prevent thrombocytopenia associated with the EAP regimen for hematopoietic stem cell mobilization. The EAP regimen consists of etoposide, cytarabine, and pegylated granulocyte colony-stimulating factor (pegfilgrastim) and is used for hematopoietic stem cell mobilization before autologous stem cell transplantation in patients with multiple myeloma and B-cell lymphoma. Severe thrombocytopenia is a common complication during EAP-based stem cell mobilization and may increase the risk of bleeding and the need for platelet transfusions, and may sometimes delay stem cell collection. In this study, patients whose platelet counts decrease to ≤80 × 10⁹/L after EAP chemotherapy will receive rhTPO early as a preventive treatment. The study will evaluate whether early rhTPO administration can reduce the incidence of clinically significant bleeding and the need for platelet transfusion while maintaining adequate hematopoietic stem cell mobilization. The study will also monitor platelet counts, stem cell collection outcomes, and treatment-related adverse events to evaluate the effectiveness and safety of early rhTPO administration.
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Inclusion Criteria: 1. Age between 18 and 75 years old. 2. Confirmed diagnosis of multiple myeloma or B-cell lymphoma, eligible for autologous hematopoietic stem-cell transplantation and planned to receive EAP-based stem-cell mobilization. 3. Baseline peripheral platelet count ≥ 80 × 10⁹/L. 4. Adequate cardiac, hepatic and renal function to tolerate EAP-combination chemotherapy. 5. Willing and able to complete the full-study follow-up procedures. 6. Voluntarily provide written informed consent. Exclusion Criteria: 1. Previous history of arterial or venous thromboembolism including pulmonary embolism. 2. Liver cirrhosis or baseline alanine transaminase (ALT) \> 2 times upper limit of normal. 3. Active uncontrolled infection. 4. Confirmed myelofibrosis. 5. Pregnant or lactating female subjects. 6. Known hypersensitivity to recombinant human thrombopoietin (rhTPO).