重组人血小板生成素治疗老年急性髓系白血病化疗后血小板减少的效果观察

Effect of rhTPO on chemotherapy-induced thrombocytopenia in elderly patients with acute myeloid leukemia

目的观察重组人血小板生成素(rhTPO)治疗急性髓系白血病(AML)老年患者化疗后血小板减少的效果及安全性。方法选择2016年6月至2018年6月郑州大学人民医院收治的50例老年AML患者为研究对象;化疗后出现重度血小板减少时,使用rhTPO促进血小板恢复者纳入治疗组(28例),未使用rhTPO者纳入对照组(22例)。当血小板计数<20×10^9/L时,两组都予以间断输注血小板。比较两组血小板计数恢复持续时间及不良反应发生情况。结果治疗组血小板计数恢复至≥20×10^9/L的时间为(6.1±1.8)d,对照组为(6.7±2.1)d,两组比较差异未见统计学意义(P>0.05)。治疗组血小板恢复至≥50×10^9/L及正常(即≥100×10^9/L)所需时间分别为(9.9±1.5)、(11.4±2.4)d,对照组为(11.5±1.6)、(14.8±3.2)d,两组比较差异有统计学意义(P<0.05)。治疗组共输注血小板(5.8±1.7)U,对照组为(7.4±1.8)U,差异有统计学意义(P<0.05)。两组使用rhTPO治疗过程中未出现明显不良反应。结论rhTPO可有效改善老年AML患者化疗后血小板减少,其应用耐受性好,并可减少输血量。

Objective To analyze the safety and therapeutic effect of recombinant human thrombopoietin(rhTPO)on chemotherapy-induced thrombocytopenia in senile patients with acute myeloid leukemia(AML).Methods Fifty elderly patients with AML admitted to People’s Hospital of Zhengzhou University from June 2016 to June 2018 were selected as research objects.According to whether rhTPO was used to treat thrombocytopenia after chemotherapy,they were divided into treatment group(28 cases)and control group(22 cases).When levels of platelets was below 20×10^9/L,patients of the two groups were infused with blood platelets continually.Recovery time of platelet counts and adverse reactions were compared between the two groups.Results The time of platelet count of treatment group recovered to≥20×10^9/L was(6.1±1.8)d,and the time of control group was(6.7±2.1)d,however,the difference was not statistically significant(P>0.05).The time of platelets count recovered to≥50×10^9/L and normal(≥100×10^9/L)in treatment group were(9.9±1.5)d and(11.4±2.4)d,respectively;and they were(11.5±1.6)d and(14.8±3.2)d in control group;the difference was statistically significant between the two groups(P<0.05).Patients in treatment group were infused with platelets(5.8±1.7)U,and patients in control group were infused with(7.4±1.8)U of platelets,moreover,the difference was statistically significant(P<0.05).No significant adverse reactions occurred during the treatment with rhTPO.Conclusions rhTPO is effective in the treatment of thrombocytopenia after chemotherapy in elderly patients with AML,with good tolerance and reduced platelet transfusion.