重组人血小板生成素对白血病患者造血干细胞移植后血小板的影响

Effect of Recombinant Human Thrombopoietin on the Platelet after Hematopoietic Stem Cell Transplantation in Patients with Leukemia

目的观察重组人血小板生成素(rhTPO)对白血病患者造血干细胞移植后巨核细胞系造血及血小板恢复的影响和不良反应。方法24例行异基因外周血造血干细胞移植的急、慢性白血病患者,随机分为治疗组和对照组,治疗组于移植后7天起应用rhTPO15000U/天,对照组主要采用对症治疗。结果治疗组血小板计数由最低值恢复至>20×109/L的时间平均为13.8天,对照组为19天,较治疗组延长5.2天,差异有统计学意义(P<0.01);治疗组血小板计数由最低值恢复至>50×109/L的时间平均为19.7天,对照组为26.3天,较治疗组延长6.6天,差异有统计学意义(P<0.01);治疗期间,治疗组平均输注单采血小板2次,对照组输注4.8次,较治疗组增加2.8次,差异有统计学意义(P<0.01);28天时对照组骨髓产板型巨核细胞的数量平均为4.8个,治疗组为12.2个,较对照组增加7.4个,差异有统计学意义(P<0.01)。不良反应以乏力、头晕、头痛、注射部位疼痛为主,严重程度均为Ⅰ-Ⅱ度。结论rhTPO对白血病患者造血干细胞移植后巨核细胞系造血及血小板的恢复疗效确切,不良反应轻微,耐受性好。

Objective To explore the effect and toxicity profile of recombinant human thrombopoietin（rhTPO）on the platelet after hematopoietic stem cell transplantation in patients with leukemia. Methods 24 patients with acute or chronic leukemia treated by allogeneic peripheral blood stem cell transplantation（PBSCT） were randomly divided into the test group and the control group. The patients in the test group were treated with rhTPO since the 7th day after PBSCT（15000u/d）, while the control group were given symptomatic treatment. Results The average time for the platelet to recover to the level of 20×10^9 / L was 13.8 days in the test group, and 19 days in the control group respectively. There was significant difference（P〈0. 01）. The average time for the platelet to recover to the level of 50×10^9/L was 19.7 days in the test group,and 26.3 days in the control group respectively. There was also significant difference （P〈0.01） . The average time for the platelet transfusion was 2 in the test group,4.8 in the control group. There was significantly different （P〈0.01）. The average number of megakaryocytes was 12.2 in the test group, 4.8 in the control group on 28th day after the transplantation,and there was significant difference （P〈0.01）. The main side effects of rhTPO were debility, headache, dizzy and pain of injection site, and the degree was all Ⅰ-Ⅱ grade. Conclusion It has definite recuperative effect on the recovery of the platelet after PBSCT. There is little side effect, and it can be accepted.