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〔1〕

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

目的：评价重组人血小板生成素（rhTPO）治疗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（对照组）化疗后血小板（PLT）≤75×10^9/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组和B组（治疗组）,每组19例.A组：第2周期化疗前3天开始皮下注射rhTPO（15 000U）,每日1次,连用7d；B组：第2周期化疗结束后6～24 h注射rhTPO（15 000 U）,每日1次,连用7d.结果：与对照组相比,A组和B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组与B组比较,血小板最低值、血小板≤50×10^9/L持续时间及血小板恢复至≥100×10^9/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.

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. Methods ： Crossover study was performed. Thirty -eight patients with solid tumor who had platelet count ≤75 ×10^9/L after the first chemotherapy cycle （control group） were enrolled into this study. At the beginning of the second cycle group A and group B, treatment group, patients in group A received rhTPO subcutaneously administered 3 days before the chemotherapy at a dosage of 15 000 U every day for 7 days. In group B,rhTPO was subcutaneously administered 6 - 24 h after the chemotherapy at a dosage of 15 000 U every day for 7 days. Results ： There was a statistically significant difference in the extent and duration of the chemotherapy - induced thrombo- cytopenia among group A and B and control group （ P 〈 0.05 ）. The lowest value of platelet, the duration of the platelet count ≤ 5 0 ×10^9/ L and the time of platelet count ≥ 1 0 0 ×10^9 / L were significantly shorter in group A than those in group B （ P 〈 0.01 ）. Conclusion：Recombinant human thrombopoietin ean be effectively and safely administered to relieve the extent and du- ration of chemotherapy - induced thrombocytopenia in patients with solid tumor. Better effect can be achieved when adminis- tered before the second chemotherapy cycle.