Thrombocytopenia is a significant clinical problem, although platelet (PLT) transfusions can provide a temporary solution, they do not address the underlying cause. Management of chemotherapy-induced thrombocytopenia (CIT) often involves dose reductions or treatment delays. rhTPO increases PLT, the peak response of rhTPO is delayed, so it's important for prophylaxis. The purpose of this study is to evaluate the effectiveness of prophylaxis of rhTPO.
To observe 2∼4 chemotherapy cycles of patients with Lymphoma and lung cancer. The medication of rhTPO is prophylaxis or treatment according to rhTPO specification and Chemotherapy induced thrombocytopenia China experts consensus (2014): Treatmentmedication is to use rhTPO when patients PLT count ≤75 × 109/L; Secondary prophylaxis is to start use rhTPO before or after chemotherapy medication when patients have high risk factor of bleeding.
Prophylaxis cycles (n = 36) compared with treatment cycles (n = 55): doses of rhTPO are respectively (mean±Sd) 80417±51980 and 99273±54044 U (p = 0.173), Days of platelet recovery to 100 × 109/L are 1.6±5.4 and 12.9±16.5 (p = 0.489), PLT nadir is (56.3±41.0)×109/Land(41.4±34.8)×109/L (p = 0.088), CIT incidence is 72.2% and 94.5% (p = 0.045), needs for PLT transfusion are 6 with 1.7±1.0 U and 7 with 2.0±1.5 U (p = 0.806). Prophylaxis before chemotherapy compared with themselves cycle 1 treatment medication (n = 3): PLT nadir is (89.3±45.9)×109/L and (28.0±27.1)×109/L (p = 0.117). Prophylaxis cycles with Cytosine arabinoside (n = 5), Plutinum (n = 8), anthracycline (n = 14), others (n = 4): the day of PLT nadir occurred during chemotherapy cycle are 10.8±4.4, 15.1±5.4, 10.4±6.0 and 9.0±5.4 (p = 0.212).
There is a trend that prophylaxis of rhTPO is more effective than treatment medication. Prophylaxis could shorten days of PLT recovery, increase PLT nadir, decrease CIT incidence and PLT transfusion, while with less dose of rhTPO. In addition, it seems that prophylaxis of rhTPO before chemotherapy has better effectiveness of increasing PLT nadir, the day of PLT nadir ocurred of chemotherapy regimen with Platinum is later than others.
Clinical trial identification
Legal entity responsible for the study
Jiansu Cancer Hospital
Shenyang Sunshine Pharmaceutical Co., Ltd.
All authors have declared no conflicts of interest.