粒细胞集落刺激因子致血小板计数异常的文献病例分析

Literature Case Analysis of Platelet Count Abnormality Induced by Granulocyte Colony Stimulating Factor

目的分析粒细胞集落刺激因子致血小板计数异常(减少或增多)的发生特点,为其临床安全使用提供参考。方法检索建库至2021年1月7日MEDLINE、中国知网、万方、维普和中国生物医学文献数据库发表的关于粒细胞集落刺激因子致血小板计数异常的病例报道并进行统计和描述性分析。结果粒细胞集落刺激因子致血小板计数异常的病例报道共计11例,均发生在使用粒细胞集落刺激因子期间,其中男性8例(72.7%),女性3例(27.3%);年龄4 d~75岁(39.5±24.9)岁;引起血小板计数减少的有7例(63.6%),引起血小板计数增多的有4例(36.4%);出现并发症的有8例(72.7%),以血栓和出血事件居多;所有病例经停药、减量和对症治疗后血小板计数均有明显改善且并发症消退。结论粒细胞集落刺激因子致血小板计数异常较为罕见,其中以血小板减少相对多见。临床在使用粒细胞集落刺激因子期间应加强对血小板计数的监测,一旦发现异常变化应及时停药和对症处理,减少血栓或出血事件的发生。

OBJECTIVE To analyze the characteristics of platelet count abnormality(decrease or increase) induced by granulocyte colony stimulating factor(G-CSF) in order to provide references for its clinical rational drug use. METHODS MEDLINE, CNKI, Wanfang, VIP and CMB from the establishment of each database to January 7, 2021 were searched for platelet count abnormality induced by G-CSF, and the collected literatures were further analyzed statistically. RESULTS A total of 11 cases were identified and included in the analysis, all of which occurred during the period of using G-CSF. Among them, there were 8 males(72.7%) and 3 females(27.3%);aged from 4 days to 75 years old;7 cases(63.6%) decreased and 4 cases(36.4%) increased;8 cases(72.7%) had complications, most of which were thrombosis and bleeding events. The platelet count were significantly improved and the complications were resolved after withdrawal, reduction and symptomatic treatment in all cases. CONCLUSION Platelet count abnormality caused by G-CSF is relatively rare, and decrease is more common among them. The monitoring of platelet count should be strengthened during using G-CSF. Once platelet count abnormality occurs, G-CSF should be stopped and and symptomatic treatment should be given to reduce the risk of thrombosis or bleeding events.