重组人血小板生成素治疗肿瘤化疗后血小板减少的临床观察

目的:评价重组人血小板生成素(recombinant human thrombopoietin,rhTPO)对肿瘤化疗后血小板减少的疗效和不良反应。方法:采用自身对照交叉研究方法,对第1周期(对照周期)化疗后PLT≤75×109/L的38例实体肿瘤患者于第2周期采用相同化疗方案,随机分为A、B两组,每组19例患者。A组:第2周期化疗前3天开始皮下注射rhTPO(15 000μ),每日1次,连用7 d;B组:第2周期化疗结束后6~24 h注射rhTPO(15 000μ),1次/d,连用7 d。结果:与对照周期相比,A、B两组血小板减少程度和持续时间差异有统计学意义(P<0.05);A、B两组比较,血小板最低值、血小板≤50×109/L持续时间及血小板恢复至≥100×109/L时间差异有统计学意义(P<0.01)。结论:rhTPO可减少PLT降低程度和持续时间,提前给药效果更佳,且无严重不良反应。

The Clinical evaluation of recombinant human thrombopoietin in the treatment of chemotherapy-induced thrombocytopenia in patients with solid tumor

Objective To evaluate the efficacy and side effects of recombinant human thrombopoietin （rhTPO） in the treatment of chemotherapy-induced thrombocytopenia in patients with solid tumors.Method Crossover study was performed.Thirty-eight patients with solid tumor who had platelet count≤75 × 10^9/L after the first chemotherapy cycle （control cycle） were enrolled into this study.At the beginning of the second cycle,patients in group A received rhTPO subcutaneously administered 3 days before the chemotherapy at a dosage of every day for 7 days.In Group B,rhTPO was subcutaneously administered 6 ~ 24 h after the chemotherapy at a dosage of every day for 7days.Results There was a statistically significant difference in the extent and duration of the chemotherapy-induced thrombocytopenia among group A and B and control group （P〈0.05） .The lowest value of platelet,the duration of the platelet count≤50 × 10^9/L and the time of platelet count≥100 × 10^9/L were significantly shorter in group A than those in group B （P〈0.01） .Conclusion Recombinant human thrombopoietin can be effectively and safely administered to relieve the extent and duration of chemotherapy-induced thrombocytopenia in patients with solid tumor.Better effect can be achieved when administered before the second chemotherapy cycle.