重组人血小板生成素可预防恶性肿瘤化疗后血小板减少

Prophylactic recombinant human thrombopoietin treatment alleviates chemotherapy-induced thrombocytopenia in tumor patients

目的观察重组人血小板生成素(rhTPO)预防应用治疗恶性肿瘤患者化疗后血小板减少的临床疗效。方法采用随机交叉自身对照研究,24例恶性肿瘤患者随机分为A、B两组,每组12例,接受方案和剂量相同的两个周期化疗。A组:第1个周期(对照周期)不注射rhTPO,第2个周期(用药周期)化疗前3 d开始注射rhTPO;B组:第1个周期(对照周期)不注射rhTPO,第2个周期(用药周期)化疗后6～24 h内注射rhTPO。结果 24例恶性肿瘤患者用药周期与对照周期血小板减少程度和持续时间差异有显著性;A、B两组用药周期与对照周期血小板减少程度和持续时间差异有统计学意义。结论恶性肿瘤患者化疗前提前给予国产rhTPO可明显提高化疗后血小板的最低值,以及缩短化疗后血小板恢复时间。

Objective To assess the efficacy of prophylactic treatment with recombinant human thrombopoietin （rhTPO） on chemotherapy-induced thrombocytopenia in tumor patients. Methods In this randomized cross-over self-controlled clinical trial, 24 patients with malignant neoplasms were randomized group A （12 cases） and group B （12 cases）. All the patients underwent two identical cycles of chemotherapy. In group A, RhTPO （1.0μg/kg） was administered subcutaneously on a daily basis 3 days before the second chemotherapy cycle for 7 consecutive days, and in group B, RhTPO was administered daily 6-24 h after the second chemotherapy cycle for 7 days. In both groups, RhTPO was not administered in the first chemotherapy cycle, which served as the control cycle. Results In both the groups, platelet count was significantly higher in the second cycle than in the control cycle, and the duration of thrombocytopenia was significantly shortened in the second cycle. Compared with group B, the patients in group A showed a significantly higher platelet count in the second cycle and a significantly shorter duration of thrombocytopenia in the second cycle. Conclusion Prophylactic administration of rhTPO can significantly reduce the severity and duration of thrombocytopenia and promote platelet recovery in patients undergoing chemotherapy for malignant tumors.